Comparison of PENG Block and FICB in Hip Fracture Patients

Asan Medical Center80 enrolled

Overview

Fascia iliaca compartment block (FICB) has been considered the block of choice for patients with hip fracture. However, pericapsular nerve group (PENG) block, one of the relatively newly-developed blocks, could be also used for analgesia in patients with hip fracture. Since PENG block could block the accessory obturator nerve, PENG block might have greater analgesic effects compared to FICB theoretically. However, the comparison of these two blocks in patients with hip fracture has not performed in clinical setting. Thus, we aimed to compare the analgesic effect of PENG block and FICB.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

Conditions

Hip Fractures Regional Anesthesia

Interventions

Pericapsular nerve group (PENG) blockPROCEDURE

ultrasound-guided PENG block with 0.3% ropivacaine 20cc

Fascia iliaca compartment block (FICB)PROCEDURE

ultrasound-guided suprainguinal FICB with 0.3% ropivacaine 30cc

Eligibility

Sex: ALLMin age: 19 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ASA PS 1-4 * age: ≥19 * baseline pain score (associated with hip fracture): ≥4 Exclusion Criteria: * patients who do not agree to participate in this study * patients with uncontrolled hypertension, hyperthyroidism, severe dementia * allergic to ropivacaine * contraindicated to spinal anesthesia due to coagulopathy, severe aortic stenosis/mitral stenosis, or active infection on lumbar region * patients who are considered ineligible with any other reason by investigators

Locations (1)

Asan Medical Center

Seoul, South Korea

Outcomes

Primary Outcomes

Efficacy of each block (Pain score)

We will assess the dynamic pain (pain during a movement) using NRS before and 20-30min after applying the assigned block. Then, we will calculate the change of NRS at the two time-points. NRS: Numerical rating scale (0, no pain; 10, the worst pain imaginable)

Time frame: before surgery

Secondary Outcomes

change of blood pressure (systolic, diastolic, mean blood pressure)

We will evaluate the blood pressure before and 20-30min after applying the assigned block. Then, we will calculate the change of blood pressure at the two time-points.

Time frame: before surgery

postoperative pain score

resting and dynamic pain using NRS at postoperative 6, 24, 48hours NRS: Numerical rating scale (0, no pain; 10, the worst pain imaginable)

Time frame: postoperative 6, 24, 48hours

postoperative opioid consumption

morphine-equivalent dose

Time frame: postoperative 24, 48hours

postoperative motor function

motor function of quadriceps femoris grade5: normal power grade4: movement possible against some resistance grade3: movement against gravity but not resistance grade2: movement possible if gravity eliminated grade1: flicker of contraction possible grade0: complete paralysis

Time frame: postoperative 6, 24, 48hours

change of heart rate

We will evaluate the heart rate before and 20-30 min after applying the assigned block. Then, we will calculate the change of heart rate at the two time-points.

Time frame: before surgery

Data from ClinicalTrials.gov

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