The hypothesis of this study is that patients who undergo PENG block in before Total Hip Artroplasthy (THA) surgery with spinal anesthesia will have reduced postoperative pain scores, less need for opioid analgesics and earlier mobilisation.
This prospective randomised controlled study included a total of 60 patients aged 40-85 years who underwent THA surgery under spinal anaesthesia. Patients were divided into two groups as PENG block (n:30) and non-PENG block (n:30). PENG block was placed in the fascial plane between the pseudotendon and pubic ramus with USG in-plane technique, 20 ml of 0.5% bupivacaine was administered and surgery was initiated. The primary outcome of the study was to investigate the effect of preoperative PENG block application on postoperative pain, opioid requirement, mobilisation time, hip joint patency and length of hospital stay in patients undergoing THA surgery. The secondary outcome was to investigate the effect of PENG block on perioperative haemodynamics and postoperative side effects. For multimodal analgesia, 10 ml 0.5% bupivacaine + 10 ml 2% lidocaine is infiltrated into the surgical wound incision line by the surgical team at the end of surgery. After tramadol 50 mg loading with PCA device, a basal rate of 5-10 mg/hour (20 mg bolus dose + 30 minutes lock time) is given with paracetamol 10 mg/kg iv (8 hours interval).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
With ultrasonography-guided PENG block, the femoral, obturator and accessory obturator nerve branches that provide sensory innervation of the anterior surface of the hip joint capsule are blocked .
UmraniyeERH
Istanbul, Umraniye, Turkey (Türkiye)
RECRUITINGpostoperative pain score
VAS pain score
Time frame: recovery room 30 min, 12., 24. and 48. hours in the postoperative period
mobilisation time
walking 5 steps with walker
Time frame: 24 -48 hours
hip joint patency
Measurement of joint movement angle with goniometer (angle)
Time frame: 24. hours
total opioid consumption
Tramadol total usage (mg)
Time frame: 48 hours
PENG block side effects
motor block, nausea, vomiting, anaphylaxis, nerve damage
Time frame: The first 48 hours after performing the PENG block
Perioperative haemodynamic data
heart rate, mean arterial pressure
Time frame: T1: 30 minutes (min) after spinal anesthesia, T2: at the end of the surgical procedure, T3: at 30 minutes after recovery
length of hospital stay
hospitalization and discharge time for surgery
Time frame: day
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