Femoral Rami Obturator Nerve Trunk (FRONT) Block in Intramedullary Nail Surgery .

NCT ID: NCT07268911

Last Updated: 2025-12-16

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-11-01
• Study Completion Date: 2026-06-30

Brief Summary

The study propose that using femoral rami obturator nerve trunk(FRONT) block may help postoperative analgesia in nail femur surgeries. The technique is relatively new, introducing one needle to target two nerve blocks in the same entry point. The block spare motor fibers of femoral nerve so it may help both early mobilization and effective analgesia, which in turn enhance early recovery and better outcomes.

Detailed Description

Post operative pain levels after hip fracture are high during ambulation and may worsen outcome after hip fracture. Regional anesthesia has shown to facilitate rehabilitation in orthopedics procedures. Many of these regional anesthesia techniques ,such as femoral nerve, lumber plexus, peri capsular nerve group(PENG), fascia iliaca blocks have gained attention for their opioid and some times for motor sparing potential, as well as the ability to provide targeted analgesia for anterior hip joint. Nevertheless the anterior hip joint coverage needs the constant contribution of femoral and obturator nerves to provide adequate pain relieve. In this study patients will receive preoperative femoral rami obturator nerve trunk(FRONT) block , a novel regional anesthesia technique described by Jessen et al., as a promising solution to the long-standing challenge of anesthetizing both the femoral and obturator nerve branches in anterior hip joint for postoperative pain control, addressing a more comprehensive coverage of anterior hip innervation.

Conditions

Anterior Hip Analgesia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Block Group

will receive FRONT block

Group Type: ACTIVE_COMPARATOR

Femoral rami obturator nerve trunk (FRONT) block

Intervention Type: PROCEDURE

ultrasound-guided FRONT block will be performed at the infrainguinal level, targeting the iliopsoas plane. Using the same needle approach, the subpectineal compartment will be also accessed . We will use ultrasound and electrical nerve stimulation guidance (0.4 mA, 0.1 ms, without eliciting a motor response) to avoid direct involvement of the femoral nerve. A total of 40 mL (20 mL for the iliopsoas plane and 20 mL for the subpectineal compartment) of 0.125% plain levobupivacaine will be administered.

Control group

will receive conventional analgesia

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Femoral rami obturator nerve trunk (FRONT) block

ultrasound-guided FRONT block will be performed at the infrainguinal level, targeting the iliopsoas plane. Using the same needle approach, the subpectineal compartment will be also accessed . We will use ultrasound and electrical nerve stimulation guidance (0.4 mA, 0.1 ms, without eliciting a motor response) to avoid direct involvement of the femoral nerve. A total of 40 mL (20 mL for the iliopsoas plane and 20 mL for the subpectineal compartment) of 0.125% plain levobupivacaine will be administered.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• the elderly age≥60 years
• American Society of Anesthesiologists (ASA) classification 1-2
• patients who undergoing surgery for intramedullary nail surgery.

Exclusion Criteria

• patient refused to participate and consent
• patients with a history of mild cognitive impairment (MCI), dementia, and delirium
• patients with known preoperative infections (pulmonary infection, urinary infection, and sepsis).
• coagulopathy

• Minimum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

South Valley University

OTHER

Sponsor Role: lead

Responsible Party

Mohamed Gaber Ahmed

lecturer in anesthesia, Intensive Care and Pain Management

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Zeinab M Sayed, MD

Role: STUDY_DIRECTOR

Qena University

Locations

Qena University

Qina, Qena Governorate, Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

Zeinab M Sayed, MD

Role: CONTACT

zeinab5aton@gmail.com

01009071365 ext. +02

Facility Contacts

ZAINAB MOSTAFA

Role: primary

zeinab5aton@gmail.com

002- 0100-9071365

Other Identifiers

ِAIP029-4

Identifier Type: -

Identifier Source: org_study_id