Hip Fracture Surgeries
Conditions
Keywords
hip surgeries, positioning for spinal anesthesia, PENG block, LCFN block
Brief summary
To evaluate and compare the effectiveness of the Pericapsular Nerve Group (PENG) block alone versus the PENG block combined with the Lateral Femoral Cutaneous Nerve (LFCN) block in providing adequate analgesia for patient positioning during spinal anesthesia in individuals undergoing surgery for hip fracture.
Detailed description
Hip fractures are common among adult patients and often necessitate urgent surgical intervention. Positioning these patients for spinal anesthesia in sitting position is often difficult due to intense pain from the fracture. PENG block is a novel regional technique that targets the articular branches of the femoral nerve, obturator nerve, and accessory obturator nerve, providing excellent anterior hip analgesia sparing the motor function. It is performed under ultrasound guidance and has shown promising results in perioperative pain management. By combining LFCN block with the PENG block, more complete sensory blockade may be achieved. The effectiveness of this combination has not yet been adequately studied, particularly regarding positioning for spinal anesthesia. Therefore, this trial aims to compare the analgesic efficacy of PENG block alone versus PENG +LFCN block in this specific context.
Interventions
PROCEDUREPENG Block
Pericapsular Nerve Group Block
PROCEDURELCFN block
Lateral Femoral Cutaneous Nerve block
DRUGbupivacaine 0.25%.
0.25% of Bupivacaine (Bupivacaine 0.5% is added to Lidocaine 2% in the same volume)
DRUGXylocaine 2 %
local infilteration at the insertion site
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-70 years. * ASA I-II. * Confirmed primary unilateral hip fracture. * Scheduled for surgery under spinal anesthesia. * Patients able to provide informed consent.
Exclusion criteria
* Allergy to local anesthetics. * Coagulopathy or on anticoagulant therapy. * Infection at injection site. * Pre-existing neurological deficits in the lower limbs. * Multiple trauma or polytrauma (If other injuries might interfere with positioning or pain scoring). * Previous surgery on the ipsilateral hip affecting anatomy or nerve distribution.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To compare the time taken to achieve optimal positioning for spinal anesthesia in both groups | from initiation of patient positioning until optimal positioning is achieved during the spinal anesthesia procedure | time taken in seconds for positioning for spinal anesthesia 15 minutes post- block |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To assess Numerical Rating Pain Score in both groups at 0,5,10 and 15 minutes post block | at baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block | It refers to the common method used in healthcare where patients rate their pain on a scale from 0 to 10 (0 = No pain 10 = Worst pain imaginable). |
| To assess patient satisfaction and comfort during positioning using Likert scale | during patient positioning 15 minutes after completion of the block | 5-Point scale (1=strongly disagree and 5=strongly agree). The participants measure it 15 minutes post- block during positioning for spinal anesthesia |
| To monitor mean arterial blood pressure | at baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block | Comparing mean arterial blood pressure between the 2 groups by millimeter of mercury (mmhg) at 0,5,10 and 15 minutes post-block. |
| To monitor heart rate | At baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block | Comparing the heart rate ( by beats per minute) in the 2 groups at 0,5,10 and 15 minutes post-block. |
Countries
Egypt
Contacts
CONTACTMaha Salah, lecturer
Outcome results
None listed