Pericapsular Nerve Group Block: An Imaging Study for Determination of the Spread of the Injectate Using 3-D CT Scan

NCT ID: NCT06062134

Last Updated: 2024-05-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 10 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-10-18
• Study Completion Date: 2023-12-21

Brief Summary

Over the last 20 years, different interventional regional analgesia techniques have been proposed to treat pain after hip surgeries.

The most commonly used techniques are the fascia iliaca and femoral nerve blocks, resulting in reduced pain scores, opioid-sparing effects, and opioid-related adverse effects. However, these interventional analgesia techniques result in a motor block and muscle weakness of the quadriceps muscle, impeding early ambulation and rehabilitation.

Recently, the pericapsular nerve group (PENG) block has been proposed as an effective choice for analgesia after hip surgeries while sparing the motor function of the lower extremities. The aim of this technique is to inject local anesthetic to target the more distal sensory branches innervating the anterior aspect of the hip joint.

Detailed Description

Ten patients scheduled for hip surgery were included after Ethical Committee approval and informed consent were obtained.

Preoperatively, patients received an ultrasound-guided pericapsular nerve group block. The injections were performed preoperatively using a Canon US Applio 700 with a linear transducer (14 to 6 MHz), and a 21-gauge, 80 mm stimulating needle (SonoPlex Stim, Pajunk ® ️ GmbH, Germany). After confirmation of the correct needle tip position with 2 mL of sodium chloride 0.9%, 20 mL of injectate containing 18 mL ropivacaine 0.5% with 2 mL of radiopaque contrast (Iomeron 300: 61.24% w/v of Iomeprol equivalent to 30% iodine or 300 mg iodine/mL (Bracco UK Limited)) was injected.

After surgery, high-definition CT scans (Siemens) were obtained to determine the distribution patterns of the injectates.

Conditions

Post Operative Pain; Mechanisms of Analgesia

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: BASIC_SCIENCE
• Blinding Strategy: NONE

Study Groups

Pericapsular nerve group block group

All subjects enrolled in the study received a pericapsular nerve group block using a local anesthetic mixed with a contrast agent. After injection, subjects were transferred to the CT scan to obtain a 3D reconstruction to determine the spread of the injectate.

Group Type: EXPERIMENTAL

Pericapsular nerve group block

Intervention Type: PROCEDURE

Ultrasound-guided injection of local anesthetic mixed with contrast agent underneath the iliopsoas muscle, lateral to the iliopsoas tendon.

18 mL ropivacaine 0.5% + 2 mL radiopaque contrast

Intervention Type: DRUG

20 mL of injectate: 18 mL ropivacaine 0.5% + 2 mL radiopaque contrast (Iomeron 300: 61.24% w/v of iomeprol equivalent to 30% iodine or 300 mg iodine/mL)

Interventions

Pericapsular nerve group block

Ultrasound-guided injection of local anesthetic mixed with contrast agent underneath the iliopsoas muscle, lateral to the iliopsoas tendon.

Intervention Type: PROCEDURE

18 mL ropivacaine 0.5% + 2 mL radiopaque contrast

20 mL of injectate: 18 mL ropivacaine 0.5% + 2 mL radiopaque contrast (Iomeron 300: 61.24% w/v of iomeprol equivalent to 30% iodine or 300 mg iodine/mL)

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

1. an indication for PENG blocks for postoperative pain management

2. American Society of Anesthesiologists (ASA) physical status I or II

3. at least 18 years old, and able to understand the purpose and risks of the study

Exclusion Criteria

1. pregnancy

2. body mass index above 35 kg/m2

3. hepatic or renal insufficiency

4. history of allergic or adverse reactions to local anesthetics or contrast agents.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Philippe Gauthier

OTHER

Sponsor Role: lead

Responsible Party

Philippe Gauthier

Principal Investigator

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Philippe Gautier

Role: PRINCIPAL_INVESTIGATOR

Anesthesiologist

Locations

Clinique Ste Anne-St Remi

Brussels, , Belgium

Countries

Belgium

References

Balocco AL, Gautier N, Van Boxstael S, Lopez AM, Carella M, Corten K, Sala-Blanch X, Hadzic A, Gautier PE. Pericapsular nerve group block: a 3D CT scan imaging study to determine the spread of injectate. Reg Anesth Pain Med. 2025 Jul 4;50(7):588-591. doi: 10.1136/rapm-2024-105459.

Reference Type: DERIVED

PMID: 38925712 (View on PubMed)

Other Identifiers

2023-146

Identifier Type: -

Identifier Source: org_study_id