PENG and LFCN Block Versus FIC Block for Multimodal Analgesia After Total Hip Replacement Surgery: a Retrospective Analysis Focused on Movement (Retro-PvF)

NCT ID: NCT06342102

Last Updated: 2025-03-19

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 80 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2024-03-26
• Study Completion Date: 2024-04-30

Brief Summary

Total hip arthroplasty is a major surgical procedure performed on a growing number of patients. Optimal pain control with limited muscle weakness is paramount for a swift initiation of physical therapy and ambulation, thus expediting hospital discharge. Amongst the many peripheral nerve blocks, FIB (fascia iliaca block) has been recommended as the block of choice by many international guidelines since it offers the best pain control with a relatively low risk of motor block. PENG (pericapsular nerve group) and its association with LFCN (lateral femoral cutaneous nerve) has been proposed as an effective alternative that offers comparable, If not better, pain control with a considerably lower risk for motor block compared to FIB. Given the novelty of this block, there are few published papers on the subject, mostly case series or case reports thus justifying the need for retrospective study.

Detailed Description

The primary outcome was the degree of residual quadriceps femoris muscle paresis assessed with the MRC (medical research council) scale at 6 hours between PENG and LCFN. The secondary outcomes were NRS (numeric rating scale) at 6,12, 24 hours, total opioid consumption expressed as milligrams of morphine equivalents (MME), time to first rescue opioid and time to first postoperative ambulation.

Conditions

Regional Anesthesia Block; Regional Anesthesia; Total Hip Replacement Surgery; Total Hip Arthroplasty \(THA\)

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: RETROSPECTIVE

Study Groups

PENG + LFCN Block

group in which PENG + LFCN Block was performed

PENG + LFCN block

Intervention Type: PROCEDURE

The PENG block was performed under ultrasound guidance. After skin disinfection, the needle was advanced between the psoas tendon and pubic ramus where 20 mL of 0.5% ropivacaine were injected. The LFCN block was performed following the PENG block.10 ml of 0.5% ropivacaine were injected near the nerve into the fat-filled flat tunnel (FFFT) located at the level of the superior anterior iliac spine and lateral to the sartorius muscle.

FIC Block

group in which FIC Block was performed

FIC block

Intervention Type: PROCEDURE

FICB was performed under ultrasound guidance. The needle was advanced above the fascia iliaca and 20 mL of 0.5% ropivacaine were injected

Interventions

PENG + LFCN block

The PENG block was performed under ultrasound guidance. After skin disinfection, the needle was advanced between the psoas tendon and pubic ramus where 20 mL of 0.5% ropivacaine were injected. The LFCN block was performed following the PENG block.10 ml of 0.5% ropivacaine were injected near the nerve into the fat-filled flat tunnel (FFFT) located at the level of the superior anterior iliac spine and lateral to the sartorius muscle.

Intervention Type: PROCEDURE

FIC block

FICB was performed under ultrasound guidance. The needle was advanced above the fascia iliaca and 20 mL of 0.5% ropivacaine were injected

Intervention Type: PROCEDURE

Other Intervention Names

pericapsular nerve group block associated with lateral femoral cutaneous nerve block; fascia iliaca compartment block

Eligibility Criteria

Inclusion Criteria

• elective total hip replacement surgery for non-traumatic hip disease,
• age over 18 years,
• complete clinical chart including type of peripheral nerve block performed,
• signed consent form for spinal anesthesia and peripheral nerve block.

Exclusion Criteria

• preoperative opioid therapy,
• having received a peripheral nerve block other than PENG + LFCN or FICB,
• having received general anesthesia,
• incomplete chart,
• documented muscle weakness
• deviation from the established post-operative analgesia protocol.

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

Sponsors

Ospedale Edoardo Bassini

OTHER

Sponsor Role: lead

Responsible Party

Francesco Vetrone, MD

Medical Doctor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

ASST Nord Milano - Ospedale E. Bassini

Cinisello Balsamo, Italy/Milano, Italy

Countries

Italy

Other Identifiers

ID 4286

Identifier Type: -

Identifier Source: org_study_id