Postoperative Analgesia, Total Hip Arthroplasty, Pericapsular Nerve Group Block, Fascia Iliaca Compartment Block
Conditions
Brief summary
The aim of this study is to compare the effectiveness of pericapsular nerve group (PENG) block versus fascia iliaca compartment block (FICB) for postoperative pain relief following total hip arthroplasty (THA).
Detailed description
Total hip arthroplasty is a widely used surgical treatment intervention for treating hip conditions such as femur neck fractures and advanced hip osteoarthritis. Hip fractures are quite common, regardless of the age of the population (young or old), and they are extremely painful. A hip fracture is a serious injury with potentially life-threatening complications, and it is a common orthopedic emergency in elderly individuals. Early surgery within 48 hours of a fracture has been found to lower mortality and complication rates. The pericapsular nerve group block is a novel regional analgesia technique to decrease pain after total hip arthroplasty (THA) while preserving the motor function. The local anaesthetic is deposited using this method in the fascial plane between the psoas muscle and the superior pubic ramus, which aims sensory branches of the obturator, accessory obturator, and femoral nerves in the anterior capsule of the hip. Fascia iliaca compartment block, for procedures on the femur and hip joint, is still a well-liked regional anaesthetic technique. Studies have found that FICB prevents complications by anaesthetizing the femoral nerve far from critical neurovascular structures while still giving enough analgesia. Both blocks could be used to effectively reduce pain intensity up to 24 hours, total opioid consumption, and length of hospital stay in THA patients.
Interventions
Patients received an ultrasound-guided supra-inguinal fascia iliaca compartment block.
OTHERPericapsular nerve group block
Patients received an ultrasound-guided pericapsular nerve group (PENG) block.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age from 18 to 80 years. * Both sexes. * American Society of Anaesthesiologists (ASA) Physical Status II-III. * Scheduled for Total hip arthroplasty (THA) under spinal anesthesia.
Exclusion criteria
* Patients' refusal * Contraindications to spinal anesthesia or nerve blocks. * History of allergy to the medications used in the study. * Pregnancy. * Significant cognitive impairment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | Degree of pain was assessed using the Visual Analogue Scale (VAS). VAS is ranging from 0 to 10, where 0 is no pain and 10 is maximum pain. VAS was recorded at 0, 2, 4, 6, 12, 18, and 24 hours postoperatively. |
| Total amount of nalbuphine consumption | 24 hours postoperatively | If the postoperative Visual Analogue Scale (VAS) was greater than 3, an intravenous dose of 5 mg Nalbuphine diluted in 5 mL of saline was administered as needed. |
| Number of cases needing rescue doses | 24 hours postoperatively | The number of cases needing rescue doses was recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative ambulation | 24 hours postoperatively | Time from completion of surgery to first assisted standing and walking ≥2 meters was recorded as the ambulation time. |
Countries
Egypt
Outcome results
None listed