PENG Block Versus Fascia Iliaca Block for Pre- and Post-Operative Analgesia in Elderly Patients With Hip Fracture

Zagazig University51 enrolled

Overview

Clinical controled trial to compare between pericapsular Nerve Group Block and Fascia Iliaca Block to find the best way to provide analgesia for elderly patients with hip fracture in the pre- and post-operative periods.

Pain is a major problem that has to be dealt with in case of hip fracture, as it resembles an obstacle for examination, positioning for receiving neuroaxial anesthesia and postoperative mobility and physiotherapy. With the introduction of ultrasound in regional anesthesia and peripheral nerve blocks, regional analgesia float to the surface as a substitute for opioids with less side effects. Of the many techniques to provide regional analgesia for hip fractures; fascia iliaca block was widely used with good results. In 2018 Pericapsular Nerve Group Block was introduced to provide regional analgesia for hip fractures with interesting results. In this study the investigators are going to compare Pericapsular Nerve Group Block and Fascia Iliaca Block to find the best way to provide analgesia for elderly patients with hip fracture in the pre- and post-operative periods.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

Conditions

Hip Fractures

Interventions

Pericapsular nerve Group blockPROCEDURE

Under ultrasound guidance a needle is inserted between the iliopectineal eminence and the iliopsoas muscle and tendon to block articular branches supplying the capsule of hip joint.

Facia Iliaca blockPROCEDURE

Under ultrasound guidance a needle is inserted between the fascia iliaca and Psoas muscle to block the femoral, obturator and lateral cutaneous nerves.

FentanylDRUG

Intravenous fentanyl in a dose of 1mic/kg divided into two boluses with 5 minutes interval in between.

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patient acceptance. 2. Accepted mental state of the patient. 3. Gender: both sexes. 4. Age above 65 years old. 5. Body mass index 18.5-35 kg/m2. 6. ASA physical status II and III. 7. Unilateral hip fracture assigned for surgical fixation. 8. Expected duration of surgery ≤ 3 hours. Exclusion Criteria: 1. Associated trauma or multiple fractures. 2. Peripheral neuropathy. 3. Coagulopathy. 4. Infection at site of injection. 5. Allergy to the drugs used in the study. 6. Advanced kidney, liver or heart disease.

Outcomes

Primary Outcomes

Comparison between the analgesic effect of both Pericapsular Nerve Group block and Fascia Iliaca block with VAS score.

Analysis of Visual Analogue Pain Score for both PENG block and FI block before and after each block during rest and movement to compare between their analgesic effect. The Visual Analogue Pain score is done by drawing a 10cm vertical line on a piece of paper with its limits "no pain" (0) on one side and "extreme pain" (10) on the other side. The patient will be asked to point where the pain (he/she) experiences lies on the line.

Time frame: Baseline

Central Contacts

khaled M Mohamed, Master degree

CONTACT

00201007575373 dr_k3@yahoo.com

Data from ClinicalTrials.gov

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