Analgesic Comparison of PENG/LFCN to FICB for Total Hip Arthroplasty

NCT ID: NCT05477641

Last Updated: 2022-08-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

105 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-28

Study Completion Date

2023-02-01

Brief Summary

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This study compares 2 commonly used interventions (regional pain blocks) used in hip arthroplasty for pain control. One of the interventions is newer and not widely established.

Detailed Description

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This study will compare the FICB to the PENG/LFCN blocks. Patient reported pain scores on a verbal numeric rating scale will be utilized and recorded in the PACU and postoperatively at 3, 6, 12, 18, 24, 36 and 48 hours after patient arrival in the PACU. Additionally, opioid consumption will be converted to morphine milliequivalents and compared between groups.

Conditions

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Analgesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized, single-blinded, controlled study
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Patient will be randomized into one of the 2 groups, but will not know which group. Also, the insertion site for both techniques is similar, so they won't be able to tell which group form that evidence either.

Study Groups

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pericapsular nerve group block and lateral femoral cutaneous nerve block

Nerve blocks

Group Type ACTIVE_COMPARATOR

Pericapsular Nerve Group Block with Lateral Femoral Cutaneous Nerve Block

Intervention Type PROCEDURE

Local anesthetic will be deposited along the lower pelvis to block 3 nerves that innervate the anterior hip capsule

Fascia Iliaca Compartment Block

Intervention Type PROCEDURE

Local anesthetic is deposited between the fascia iliaca and the internal oblique muscle in an attempt to block 3 nerves that innervate the hip.

fascia iliaca compartment block

Nerve block

Group Type ACTIVE_COMPARATOR

Pericapsular Nerve Group Block with Lateral Femoral Cutaneous Nerve Block

Intervention Type PROCEDURE

Local anesthetic will be deposited along the lower pelvis to block 3 nerves that innervate the anterior hip capsule

Fascia Iliaca Compartment Block

Intervention Type PROCEDURE

Local anesthetic is deposited between the fascia iliaca and the internal oblique muscle in an attempt to block 3 nerves that innervate the hip.

Interventions

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Pericapsular Nerve Group Block with Lateral Femoral Cutaneous Nerve Block

Local anesthetic will be deposited along the lower pelvis to block 3 nerves that innervate the anterior hip capsule

Intervention Type PROCEDURE

Fascia Iliaca Compartment Block

Local anesthetic is deposited between the fascia iliaca and the internal oblique muscle in an attempt to block 3 nerves that innervate the hip.

Intervention Type PROCEDURE

Other Intervention Names

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Suprainguinal Fascia Iliaca Block

Eligibility Criteria

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Inclusion Criteria

* Eligibility criteria for the study were: age 40-80, Physical Status I-III, BMI less than 40 kg/m2, ability to read and speak English, able to sign their own consent form and undergoing elective primary total hip arthroplasty.

Exclusion Criteria

* Patients were excluded if they were chronically prescribed opioids for a condition unrelated to their surgical hip pain, were deemed Physical Status 4 or higher, had an ongoing coagulopathy, had any infection near the site of injection, had an allergy to local anesthetics, deemed to have diabetic neuropathy, deemed to have a contraindication to spinal anesthesia or were unable to report their pain scores reliably (as in severe dementia or similar).
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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SSM Health Bone and Joint Hospital at St Anthony

OTHER

Sponsor Role lead

Responsible Party

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Patrick Myer

Chief CRNA SSM Bone and Joint Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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SSM Healthcare Bone and Joint Hosptial at St Anthony

Oklahoma City, Oklahoma, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Patrick S Myer, MSN

Role: primary

405-979-7736

References

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Bedard NA, Elkins JM, Brown TS. Effect of COVID-19 on Hip and Knee Arthroplasty Surgical Volume in the United States. J Arthroplasty. 2020 Jul;35(7S):S45-S48. doi: 10.1016/j.arth.2020.04.060. Epub 2020 Apr 24.

Reference Type BACKGROUND
PMID: 32381441 (View on PubMed)

Berlioz BE, Bojaxhi E. PENG Regional Block(Archived). 2024 Oct 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK565870/

Reference Type BACKGROUND
PMID: 33351429 (View on PubMed)

Soffin EM, YaDeau JT. Enhanced recovery after surgery for primary hip and knee arthroplasty: a review of the evidence. Br J Anaesth. 2016 Dec;117(suppl 3):iii62-iii72. doi: 10.1093/bja/aew362.

Reference Type BACKGROUND
PMID: 27940457 (View on PubMed)

Wainwright TW, Gill M, McDonald DA, Middleton RG, Reed M, Sahota O, Yates P, Ljungqvist O. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS(R)) Society recommendations. Acta Orthop. 2020 Feb;91(1):3-19. doi: 10.1080/17453674.2019.1683790. Epub 2019 Oct 30.

Reference Type BACKGROUND
PMID: 31663402 (View on PubMed)

Li J, Zhu H, Liao R. Enhanced recovery after surgery (ERAS) pathway for primary hip and knee arthroplasty: study protocol for a randomized controlled trial. Trials. 2019 Oct 22;20(1):599. doi: 10.1186/s13063-019-3706-8.

Reference Type BACKGROUND
PMID: 31640757 (View on PubMed)

Kaye AD, Urman RD, Cornett EM, Hart BM, Chami A, Gayle JA, Fox CJ. Enhanced recovery pathways in orthopedic surgery. J Anaesthesiol Clin Pharmacol. 2019 Apr;35(Suppl 1):S35-S39. doi: 10.4103/joacp.JOACP_35_18.

Reference Type BACKGROUND
PMID: 31142957 (View on PubMed)

Dalens B, Vanneuville G, Tanguy A. Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesth Analg. 1989 Dec;69(6):705-13.

Reference Type BACKGROUND
PMID: 2589650 (View on PubMed)

Zhang XY, Ma JB. The efficacy of fascia iliaca compartment block for pain control after total hip arthroplasty: a meta-analysis. J Orthop Surg Res. 2019 Jan 25;14(1):33. doi: 10.1186/s13018-018-1053-1.

Reference Type BACKGROUND
PMID: 30683117 (View on PubMed)

Giron-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular Nerve Group (PENG) Block for Hip Fracture. Reg Anesth Pain Med. 2018 Nov;43(8):859-863. doi: 10.1097/AAP.0000000000000847.

Reference Type BACKGROUND
PMID: 30063657 (View on PubMed)

Pascarella G, Costa F, Del Buono R, Pulitano R, Strumia A, Piliego C, De Quattro E, Cataldo R, Agro FE, Carassiti M; collaborators. Impact of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial. Anaesthesia. 2021 Nov;76(11):1492-1498. doi: 10.1111/anae.15536. Epub 2021 Jul 1.

Reference Type BACKGROUND
PMID: 34196965 (View on PubMed)

Sahoo RK, Jadon A, Sharma SK, Nair AS. Pericapsular nerve group (PENG) block for hip fractures: Another weapon in the armamentarium of anesthesiologists. J Anaesthesiol Clin Pharmacol. 2021 Apr-Jun;37(2):295-296. doi: 10.4103/joacp.JOACP_295_20. Epub 2021 Jul 15. No abstract available.

Reference Type BACKGROUND
PMID: 34349384 (View on PubMed)

Allard C, Pardo E, de la Jonquiere C, Wyniecki A, Soulier A, Faddoul A, Tsai ES, Bonnet F, Verdonk F. Comparison between femoral block and PENG block in femoral neck fractures: A cohort study. PLoS One. 2021 Jun 4;16(6):e0252716. doi: 10.1371/journal.pone.0252716. eCollection 2021.

Reference Type BACKGROUND
PMID: 34086782 (View on PubMed)

Kukreja P, Avila A, Northern T, Dangle J, Kolli S, Kalagara H. A Retrospective Case Series of Pericapsular Nerve Group (PENG) Block for Primary Versus Revision Total Hip Arthroplasty Analgesia. Cureus. 2020 May 19;12(5):e8200. doi: 10.7759/cureus.8200.

Reference Type BACKGROUND
PMID: 32572357 (View on PubMed)

Talawar P, Tandon S, Tripathy DK, Kaushal A. Combined pericapsular nerve group and lateral femoral cutaneous nerve blocks for surgical anaesthesia in hip arthroscopy. Indian J Anaesth. 2020 Jul;64(7):638-640. doi: 10.4103/ija.IJA_57_20. Epub 2020 Jul 1. No abstract available.

Reference Type BACKGROUND
PMID: 32792743 (View on PubMed)

Thallaj A. Combined PENG and LFCN blocks for postoperative analgesia in hip surgery-A case report. Saudi J Anaesth. 2019 Oct-Dec;13(4):381-383. doi: 10.4103/sja.SJA_299_19.

Reference Type BACKGROUND
PMID: 31572090 (View on PubMed)

17. Kim YS, Park JM, Moon YS, Han SH. Assessment of pain in the elderly: A literature review. Natl Med J India. 2017;30(4):203-207. doi:10.4103/0970-258X.218673 El-Boghdadly K, Pawa A, Chin KJ. Local anesthetic systemic toxicity: current perspectives. Local Reg Anesth. 2018;11:35-44. Published 2018 Aug 8. doi:10.2147/LRA.S15451

Reference Type BACKGROUND

Other Identifiers

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Pro00060032

Identifier Type: -

Identifier Source: org_study_id

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