To compare the impact of pericapsular nerve group block (PENG) versus the supra-inguinal fascia-iliaca compartment block (SFICB) in postoperative analgesia, opioid sparing and enhanced recovery after surgery of total hip arthroplasty by poster-lateral approach.
ASA physical status 1, 2 and 3 patients scheduled to undergo elective total hip arthroplasty by poster-lateral (Moore) surgical approach with spinal anesthesia. The investigators want to confirm the non-inferiority of the SFICB compared to the PENG block on postoperative first 6 hours after surgery NRS pain score and 48 hours opioids consumption, and the difference between these in terms of early recovery and motor impact on two first day after surgery. The principal investigator perform these regional anesthesia techniques with ultrasound guided injections.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
82
Patients scheduled for total hip arthroplasty with spinal anesthesia receive before intra-thecal injection, ultrasound-guided PENG block with injection 20 ml of ropivacaine 0,75%, between the anterior hip articular capsule, the ilii-psoas muscle, the ileo-pubic eminence and the antero-inferior iliac spine.
Patients scheduled for total hip arthroplasty with spinal anesthesia receive before intra-thecal injection, ultrasound-guided supra-inguinal fascia iliaca compartment block with injection over de inguinal ligament of 40 ml of ropivacaine 0,375%, between de ilio-psoas muscle and internal oblique muscle.
CHU de Liège
Liège, Belgium
RECRUITINGNRS 6 hours
The primary endpoint of the study will be the between-group comparisons in postoperative NRS pain scores on 0 to 10 scale.
Time frame: 6 hours after surgery
6 minutes walk test
Difference in traveled distance (metres) at six minutes walking test 48 hours after surgery
Time frame: 48 jours after surgery
Opioids secondaires side effects
Incidence of morphine related side effects in two groups
Time frame: 48 hours after surgery
QoR-15
QoR-15 French validated questionnaire for the evaluation of recovery after surgery
Time frame: 72 hours after surgery
2 minutes walk test
Difference in traveled distance (metres) at two minutes walking test 24 hours after surgery
Time frame: 24 hours after surgery
Opioid sparing
Difference in cumulated morphine consumption in first 48 hours after surgery
Time frame: 48 hours after intervention
DN4
Difference between the two groups in the DN4 questionnaire to assess the risk of persistent pain after surgery.
Time frame: 72 hours after surgery
IPO
Pain management satisfaction score by revised American Pain Society Patient Outcomes Questionnaire (APS- POQ-R).
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20 ml injection of ropivacaine 0,75%
40 ml injection of ropivacaine 0,375%
Time frame: 72 hours after surgery