Neck of femur fracture. Hip fracture,Pericapsular nerve group (PENG) block,elderly falls,opioid consumption,postoperative opioid.
Conditions
Interventions
0.25% bupivacaine with adrenaline 1:400,000 and dexamethasone 5 mg total 25 ml for pericapsular nerve group (PENG) block , musculofascial plane between the psoas muscle anteriorly and the pubic ramus
Active Comparator Procedure/Surgery,Active Comparator Procedure/Surgery
PENG block,PENG block with LFCN of thigh block
Sponsors
Faculty of medicine ,Chiangmai university.
Eligibility
Sex/Gender
All
Age
35 Years to 100 Years
Inclusion criteria
Inclusion criteria: Aged 55 years or above. Body weight 35 kg. or above. ASA classification l-lll closed fracture neck of femur.
Exclusion criteria
Exclusion criteria: - Previous hip surgery - Inability to understand and report pain severity - Decreased mental status or confusion state - Uncontrolled cardiovascular and respiratory diseases - Hepatic or renal failure - Chronic opioids use - Allergy to bupivacaine or other medications used in the protocol - Contraindications for spinal anesthesia: patient refusal, coagulopathy, increased intracranial pressure, local skin infection at needle insertion site, preload- and afterload-dependent cardiovascular disease (eg. aortic stenosis), intravascular volume depletion, sepsis, abnormal spine anatomy - Contraindications for all PNBs: patient refusal, preexisting neurological deficit, abnormal anatomy of back or inguinal area
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| opioid comsumption,effectiveness of ultrasound-guided Pericapsular nerve group (PENG)block and combined Pericapsular nerve group (PENG) with Lateral Femoral cutaneous nerve of thigh in hip fracture 24 hours after end of the intervention dose of opioid comsumption. | — |
Secondary
| Measure | Time frame |
|---|---|
| the reduce of motor weakness 24 hours after end of the intervention Oxford muscle strength grading.,efficacy of ultrasound-guided pericapsular nerve group (PENG) block combined pericapsular nerve group block (PENG) with lateral femoral cutaneous nerve (LFCN) block (imaging time + needling time Performance timeand number of needle punctures are recorded,compare safety of ultrasound-guided pericapsular nerve group (PENG) block combined pericapsular nerve group block (PENG) with lateral femoral cutaneous nerve (LFCN) block 72 hours after end of the intervention evaluated by recording incidences of complications of the PNBs including intravascular injection, paresthesia, local anesthetic systemic toxicity (LAST) | — |
Countries
Thailand
Contacts
Public ContactSratwadee Lorsomradee
Faculty of medicine,Maharaj Nakorn Chiangmai
Outcome results
None listed