Hip Fracture, Postoperative Pain
Conditions
Keywords
peng block, Pericapsular nerve group block, Hip surgery, Postoperative pain, Tramadol consumption, Regional anesthesia
Brief summary
This study aims to evaluate the effect of ultrasound-guided pericapsular nerve group (PENG) block on postoperative tramadol consumption, pain scores, and clinical outcomes in patients undergoing partial hip prosthesis surgery. Patients aged 18-75 years scheduled for surgery under general anesthesia were divided into two groups: those receiving PENG block and those not receiving the block. Postoperative tramadol consumption within the first 24 hours, visual analog scale (VAS) and numeric rating scale (NRS) scores, hemodynamic parameters, additional analgesic requirements, and recovery characteristics were recorded and compared between groups. The findings of this study are expected to contribute to optimizing multimodal analgesia strategies in hip surgery.
Detailed description
Postoperative pain management in hip surgery remains a significant clinical challenge, particularly in elderly patients. Effective analgesia is essential to reduce opioid consumption, improve patient comfort, and enhance recovery. The pericapsular nerve group (PENG) block is a relatively new regional anesthesia technique that targets the articular branches of the femoral, obturator, and accessory obturator nerves, providing analgesia to the anterior hip capsule. This prospective study was conducted to compare the clinical effects of PENG block in patients undergoing partial hip prosthesis surgery under general anesthesia. A total of 48 patients aged between 18 and 75 years were included and divided into two groups: the PENG group (Group P), which received ultrasound-guided PENG block with 20 mL of 0.5% bupivacaine after induction of general anesthesia, and the control group (Group K), which received general anesthesia alone. Demographic data, intraoperative anesthetic requirements, and postoperative parameters were recorded. The primary outcome measure was total tramadol consumption within the first 24 hours after surgery. Secondary outcomes included postoperative pain scores (VAS and NRS), hemodynamic parameters (mean arterial pressure and heart rate), remifentanil consumption, need for additional analgesia, bispectral index (BIS) values, patient comfort score, modified Aldrete recovery score, Riker agitation-sedation scale, and incidence of complications such as nausea, vomiting, hypotension, hypertension, and arrhythmia. The results of this study are intended to evaluate the effectiveness of PENG block as a component of multimodal analgesia and to determine its impact on opioid consumption and postoperative recovery in patients undergoing hip surgery.
Interventions
PROCEDUREPENG Block
Ultrasound-guided pericapsular nerve group block performed with 20 mL of 0.5% bupivacaine after induction of general anesthesia.
PROCEDUREGeneral Anesthesia
Standard general anesthesia administered without regional nerve block.
Sponsors
University of Gaziantep
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
No masking was applied in this study.
Intervention model description
Participants were randomly assigned to two parallel groups: a PENG block group receiving ultrasound-guided pericapsular nerve group block after induction of general anesthesia, and a control group receiving general anesthesia alone.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged between 18 and 75 years * Patients scheduled for partial hip prosthesis surgery * Patients classified as ASA physical status I-III * Patients who provided written informed consent
Exclusion criteria
* Known allergy to local anesthetics * Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia * Infection at the injection site * Severe systemic disease (ASA IV or higher) * Cognitive impairment preventing reliable pain assessment * Refusal to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total Tramadol Consumption Within 24 Hours After Surgery | 24 hours postoperatively | Total amount of tramadol (mg) consumed by patients during the first 24 hours after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative VAS Pain Scores | 0, 10, 30, 60 minutes and 2, 4, 6, 12, 24 hours postoperatively | Visual Analog Scale (VAS) pain scores ranging from 0 to 10, where 0 indicates no pain and 10 indicates worst imaginable pain, measured at predefined postoperative time points. |
| Postoperative NRS Pain Scores | 0, 10, 30, 60 minutes and 2, 4, 6, 12, 24 hours postoperatively | Numeric Rating Scale (NRS) pain scores ranging from 0 to 10, where 0 indicates no pain and 10 indicates worst possible pain, measured at predefined postoperative time points. |
| Intraoperative Remifentanil Consumption | Intraoperative period | Total amount of remifentanil used during surgery. |
| Additional Analgesic Requirement | 24 hours postoperatively | Requirement for additional analgesic medication in the postoperative period. |
| Postoperative Complications | 24 hours postoperatively | Incidence of complications including nausea, vomiting, hypotension, hypertension, arrhythmia, and pruritus. |
Countries
Turkey (Türkiye)
Outcome results
None listed