Anesthesia
Conditions
Brief summary
to study the effect of Pericapsular nerve group (PENG) block as a part of multimodal analgesia regimen for hip arthroplasties
Detailed description
PENG block is a novel block described by Giron-Arango in 2018 to anesthesize the anterior hip capsule as it is supplied by branches from femoral, obturator and accessory obturator nerves, sparing motor function is an additional significance So currently the block is used to reduce post operative opioid consumption, delay time rescue analgesia, facilitate positioning for spinal anesthesia for hip surgeries and to accelerate mobility and so hospital discharge saving this vulnerable group of patient from any hospital acquired pneumonia, decreasing hospital stays, and improving recovery times would provide valuable insights into its cost-effectiveness and long-term benefits for healthcare system Our primary outcome to be studied is pain assessment via Numer Rating Scale over 24 hours postoperatively, in addition to to secondary outcomes including the aforementioned advantages.
Interventions
DRUGPericapsular nerve group (PENG) block
As a part of multimodal analgesia patients will receive 20 ml of 0.25% bupivcacaine according to the technique described by Giron-Arango. All patients will receive the same analgesic protocol, which included IV paracetamol 1000 mg BID and NSAIDs if no contra-indication; PO celecoxib 100 mg BID. Also if needed nalbuphine 5 mg IV will be given as bolus demand dose and when the NRS pain score was equal to or greater than 4 points.
OTHERPatients will receive only other multimodal analgesics including LCFN block via 10 ml of 0.25% bupivacaine.
Patients will receive only other multimodal analgesics including LCFN block via 10 ml of 0.25% bupivacaine.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age group: 18 years and older. * ASA classification I to III. * BMI : 18-35 . * Gender: both sex
Exclusion criteria
* Patient refusal. * Patients on long-term pain medications. * History of allergic reactions to local anesthetics * Patients who had mental illness or uncooperative patients. * BMI \> 35 . * Patients having coagulopathies or on anticoagulant or antiplatelet therapy. * Severe cardiopulmonary disease * ASA IV or more * Diabetic or other neuropathies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain score: pain assessment using a Numeric Rating System (NRS) immediately in the postoperative period. | 24 hours | Pain score: pain intensity will be evaluated using a Numeric Rating System (NRS) immediately in the postoperative period, every 2 hours during the first 6 hours and then every 6 hours till 24 hours postoperatively. Scores ranging from 0 to 10, with 0 indicating the absence of pain and 10 indicating the worst possible pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rescue analgesia timing and opioid consumption over 24 hours | 24 hours | Time to first opioid demand and total opioid consumed by each patient individually over 24 hours. |
Countries
Egypt
Outcome results
None listed