Efficacy of Pericapsular Nerve Group (PENG) Block for Hip Surgeries

NCT ID: NCT06144931

Last Updated: 2023-11-22

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

RECRUITING

Clinical Phase

NA

Total Enrollment

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-01

Study Completion Date

2024-03-01

Brief Summary

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To study the efficacy of the PENG block on the duration of postoperative analgesia. There are two groups of patients, who are undergoing hip joint surgeries, one group (Control Group) will receive spinal anesthesia only while the other group (PENG Group) will receive PENG block before spinal anesthesia.

Detailed Description

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Research Question:

Is PENG block effective in prolonging the duration of postoperative analgesia when compared to patients undergoing spinal anesthesia only?

Research Hypothesis:

PENG block is effective in prolonging the duration of postoperative analgesia and reducing postoperative pain.

Aim:

To improve the outcome of hip joint surgeries by decreasing the postoperative pain and early mobilization by performing PENG block to patients undergoing hip joint surgeries.

Method of randomization:

This clinical trial will be randomized through computer software that generates random number table and patients will be allocated randomly to one of the two groups.

Sample size:

The sample size was determined by using the following equation:(Charan J et al. 2013) N =(2 δ\^(2 ) 〖(Z\_α+ Z\_β)〗\^2)/D\^2 δ=Standard deviation of the outcome = 6.7 (Pascarella et al., 2021). Z\_α= The value for a type I error of 5% = 1.96 Z\_β=The value for a type II error of 20% = 0.84 D\^2= The effect size = 36 (Pascarella et al., 2021).

By calculation:

N = 19 per group. So, the total sample size is 38.

Procedures:

After getting the informed consent from the patient, the patient will be allocated into one of the study groups according to randomization.

ASA standard monitors will be attached to the patient, a wide pore cannula (18G) will be inserted then a premedication with 50 -100 mcg of fentanyl and 1-2 mg midazolam intravenously will be given.

PENG group: PENG block will done under complete aseptic condition with 20 ml 0.25% bupivacaine diluted with normal saline Control group: no block will be done. Both groups will be anesthetized using spinal anesthesia with Bupivacaine

Study Variables:

Independent variables: age, sex, weight, height, body mass index (BMI), elective or emergency surgery, duration of surgery, American Society of Anesthesiologists physical status classification (ASA score), occupation, fracture site, type of trauma, timing (operating room entry- PENG block time- start of spinal anesthesia- start of surgery- end of surgery ).

Dependent variables: Postoperative pain, adverse events, and postoperative motor assessment, hemodynamics, the first request of analgesia \& total analgesia required, adverse events such as nausea vomiting \& sedation, pain scores at preparation room, after PENG block, during sitting for spinal anesthesia, at end of the surgery, postoperative intervals(rest \& movement).

Conditions

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Pain, Postoperative

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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Control Group

Patients in this group will be operated under spinal anesthesia

Group Type NO_INTERVENTION

No interventions assigned to this group

PENG Group

Patients in this group will undergo PENG block guided by ultrasound then spinal anesthesia will performed

Group Type ACTIVE_COMPARATOR

PENG Block

Intervention Type PROCEDURE

With the patient in the supine position, the ultrasound probe is placed on a transverse plane over the anterior superior iliac spine (ASIS). Once the ASIS is identified, the transducer is aligned with the pubic ramus and rotated at approximately 45 degrees, parallel to the inguinal crease. The transducer then slides medially along this axis until the anterior inferior iliac spine (AIIS), iliopubic eminence (IPE), and the psoas tendon is clearly identified, serving as anatomic landmarks. Sliding the probe distally or gently tilting the caudal will expose the head of the femur. Returning to the initial starting position, a standard 22 gauge spinal needle is inserted in-plane, from lateral to medial, in the plane between the psoas tendon and the pubic ramus. 20 ml 0.25% bupivacaine diluted with preservative free normal saline then deposited in this plane, lifting the psoas tendon. Care should be taken to avoid puncturing the psoas tendon.

Interventions

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PENG Block

With the patient in the supine position, the ultrasound probe is placed on a transverse plane over the anterior superior iliac spine (ASIS). Once the ASIS is identified, the transducer is aligned with the pubic ramus and rotated at approximately 45 degrees, parallel to the inguinal crease. The transducer then slides medially along this axis until the anterior inferior iliac spine (AIIS), iliopubic eminence (IPE), and the psoas tendon is clearly identified, serving as anatomic landmarks. Sliding the probe distally or gently tilting the caudal will expose the head of the femur. Returning to the initial starting position, a standard 22 gauge spinal needle is inserted in-plane, from lateral to medial, in the plane between the psoas tendon and the pubic ramus. 20 ml 0.25% bupivacaine diluted with preservative free normal saline then deposited in this plane, lifting the psoas tendon. Care should be taken to avoid puncturing the psoas tendon.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients with hip fracture who will be subjected to surgical treatment
* ASA physical status 1, 2

Exclusion Criteria

* Patients with chronic pain before surgery (taking opioids).
* Patients with multiple trauma
* Patients who could not assess pain reliably (dementia).
* Substance abuse and prolonged intake of sedative drugs.
* Morbid obese patients (BMI\>35).
* Patients who have open wounds or infection at the site of the block.
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Suez Canal University

OTHER

Sponsor Role lead

Responsible Party

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Aiman Ahmad Al-Touny

Lecturer of Anesthesia and Intensive Care

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Suez Canal University

Ismailia, , Egypt

Site Status RECRUITING

Countries

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Egypt

Facility Contacts

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Aiman A. Al-Touny, MD

Role: primary

01008185785

Other Identifiers

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4972#

Identifier Type: -

Identifier Source: org_study_id