This study examine the effect of Pericapsular Nerve Group (PENG) Block on analgesia after elective hip arthroplasty. Half of participants will receive a PENG Block with local anesthetic, while the other half will receive a PENG Block with a placebo.
Optimized analgesia is crucial for early mobilization after hip arthroplasty. Regional anesthesia, like fascia iliaca block or femoral nerve block, have limited indication because of motor blockade whereas local infiltrations analgesia have shown conflicting analgesic efficacy results in hip arthroplasty. Pericapsular nerve group (PENG) block is a new regional anesthesia technique targeting specifically sensory nerve branches of the hip articulation. It has been originally described in hip fracture patients. The aim of this study is to evaluate the efficacy of PENG block on analgesia after elective hip arthroplasty.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
60
After induction of general anesthesia, PENG block with 20 ml of a mixture of 1% Lidocaine with 0,5% Ropivacaine and 1/400.000 Epinephrine will be performed as described by Giron-Arongo et al with a high frequency linear probe. A 22G 80 mm needle (SonoPlex, Pajunk ) will be used.
After induction of general anesthesia, PENG block with 20 ml of 0,9% saline will be performed as described by Giron-Arongo et al with a high frequency linear probe. A 22G 80 mm needle (SonoPlex, Pajunk ) will be used.
Chu Tivoli
La Louvière, Belgium
RECRUITINGPain Score on first Mobilization
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain on first mobilization at day 0 after surgery
Time frame: Postoperative time until midnight day 0
Maximum Pain Score in Post-Anaesthesia Care Unit
Maximum Pain score evaluated in Post Anesthesia Care Unit by a a visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\])
Time frame: Through postoperative time during Post Anesthesia Care Unit stay at day 0
Morphine Consumption at Day 0
Total of Piritramid, Oxycodone and Oxycodone Extended Released expressed as equivalent of morphine at day 0
Time frame: Postoperative time until midnight day 0
Piritramid Consumption
Total of Piritramid use from the end of surgery until Post Anesthesia Care Unit discharge to the ward
Time frame: Through the end of surgery until Post Anesthesia Care Unit discharge to the ward at day 0
Morphine Consumption at Day 1
Total of Oxycodone and Oxycodone Extended Released expressed as equivalent of morphine at day 1
Time frame: Postoperative time during Post Anesthesia Care Unit stay at day 0
Morphine Consumption at Day 2
Total of Oxycodone and Oxycodone Extended Released expressed as equivalent of morphine at day 2
Time frame: Postoperative time until midnight day 2
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Pain Score at Rest 2h Postop
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain at rest 2h after surgery
Time frame: 2 hours after surgery
Pain Score on mobilization 2h Postop
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain on mobilization 2h after surgery
Time frame: 2 hours after surgery
Pain Score at Rest 4h Postop
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain at rest 4h after surgery
Time frame: 4 hours after surgery
Pain Score on mobilization 4h Postop
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain on mobilization 4h after surgery
Time frame: 4 hours after surgery
Pain Score at Rest 6h Postop
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain at rest 6h after surgery
Time frame: 6 hours after surgery
Pain Score on mobilization 6h Postop
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain on mobilization 6h after surgery
Time frame: 6 hours after surgery
Pain Score at Rest Day 1 AM
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain at rest in the morning of day 1
Time frame: Day 1 in the morning after surgery
Pain Score on mobilization Day 1 AM
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain on mobilization in the morning of day 1
Time frame: Day 1 in the morning after surgery
Pain Score at Rest Day 1 PM
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain at rest in the afternoon of day 1
Time frame: Day 1 in the afternoon after surgery
Pain Score on mobilization Day 1 PM
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain on mobilization in the afternoon of day 1
Time frame: Day 1 in the afternoon after surgery
Pain Score at Rest Day 2 AM
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain at rest in the morning of day 2
Time frame: Day 2 in the morning after surgery
Pain Score on mobilization Day 2 AM
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain on mobilization in the morning of day 2
Time frame: Day 2 in the morning after surgery
Pain Score at Rest Day 2 PM
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain at rest in the afternoon of day 2
Time frame: Day 2 in the afternoon after surgery
Pain Score on mobilization Day 2 PM
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 \[100-mm scale\]) will be used to evaluate pain on mobilization in the afternoon of day 2
Time frame: Day 2 in the afternoon after surgery
First Mobilization Success
Success rate of patients mobilized the day of surgery
Time frame: Postoperative time until midnight day 0
Mean remifentanil Infusion Rate
Total infused remifentanil dose per kg body weight per minute of total operative time
Time frame: Intraoperatively
Quadriceps weakness
Evaluation of quadriceps motricity by Neal test which consist in supporting the knee under the popliteal fossa and asking the patient to extend the knee against resistance.
Time frame: Through postoperative time during Post Anesthesia Care Unit stay at day 0