Analgesia, Postoperative Pain, Acute
Conditions
Keywords
Multimodal analgesia, pericapsular nerve group block, total hip arthroplasty, spinal anesthesia
Brief summary
The hypothesis of this study is that patients who undergo PENG block in before Total Hip Artroplasthy (THA) surgery with spinal anesthesia will have reduced postoperative pain scores, less need for opioid analgesics and earlier mobilisation.
Detailed description
This prospective randomised controlled study included a total of 60 patients aged 40-85 years who underwent THA surgery under spinal anaesthesia. Patients were divided into two groups as PENG block (n:30) and non-PENG block (n:30). PENG block was placed in the fascial plane between the pseudotendon and pubic ramus with USG in-plane technique, 20 ml of 0.5% bupivacaine was administered and surgery was initiated. The primary outcome of the study was to investigate the effect of preoperative PENG block application on postoperative pain, opioid requirement, mobilisation time, hip joint patency and length of hospital stay in patients undergoing THA surgery. The secondary outcome was to investigate the effect of PENG block on perioperative haemodynamics and postoperative side effects. For multimodal analgesia, 10 ml 0.5% bupivacaine + 10 ml 2% lidocaine is infiltrated into the surgical wound incision line by the surgical team at the end of surgery. After tramadol 50 mg loading with PCA device, a basal rate of 5-10 mg/hour (20 mg bolus dose + 30 minutes lock time) is given with paracetamol 10 mg/kg iv (8 hours interval).
Interventions
PROCEDUREPericapsular Nerve Group (PENG) Block
With ultrasonography-guided PENG block, the femoral, obturator and accessory obturator nerve branches that provide sensory innervation of the anterior surface of the hip joint capsule are blocked .
Sponsors
Umraniye Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
This prospective randomised controlled study included a total of 60 patients aged 40-85 years who underwent THA surgery under spinal anaesthesia. Patients were divided into two groups as PENG block and non-PENG block (control group).
Eligibility
Sex/Gender
ALL
Age
40 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* THA performed by posterior approach * 40-85 age range * ASA 1-3
Exclusion criteria
Under 40 years of age, over 85 years of age, * ASA 4 and above, * Cognitive impairment (Alzheimer's disease, dementia, delirium etc.), * Hip fracture, * Application site infection, * Allergy to local anaesthetic agents, * Patients are non-consenting patients.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| postoperative pain score | recovery room 30 min, 12., 24. and 48. hours in the postoperative period | VAS pain score |
| mobilisation time | 24 -48 hours | walking 5 steps with walker |
| hip joint patency | 24. hours | Measurement of joint movement angle with goniometer (angle) |
| total opioid consumption | 48 hours | Tramadol total usage (mg) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perioperative haemodynamic data | T1: 30 minutes (min) after spinal anesthesia, T2: at the end of the surgical procedure, T3: at 30 minutes after recovery | heart rate, mean arterial pressure |
| length of hospital stay | day | hospitalization and discharge time for surgery |
| PENG block side effects | The first 48 hours after performing the PENG block | motor block, nausea, vomiting, anaphylaxis, nerve damage |
Countries
Turkey (Türkiye)
Contacts
Primary Contactzeliha tuncel, ass prof
Backup Contacthale arkan tuna, specialist dr
Outcome results
None listed