Does Adding Posterior Block to SFIB Increase the Quality of Analgesia in Hip Fractures?

Samsun University68 enrolled

Overview

The researchers aimed to compare the effects of adding a Deep Posterior Gluteal Compartment Block to a Suprainguinal Fascia Iliaca Compartment Block (SFICB) versus SFICB alone on pain, analgesic consumption, and positioning pain for neuraxial anesthesia.

Adding Deep Posterior Gluteal Compartment Block to Suprainguinal Fascia Iliaca Block applied before neuraxial anesthesia in hip fracture surgeries can reduce the pain sensation originating from the posterior region of the hip joint. Thus, participants can experience less pain in the perioperative period, consume less analgesics and reduce complications related to these in the postoperative period. In addition, possible complications can be prevented with early mobilization of the participants. It was aimed to compare the effects of adding Deep Posterior Gluteal Compartment Block to Suprainguinal Fascia Iliaca Block with only Suprainguinal Fascia Iliaca Block on these results.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

DOUBLE

Enrollment

Conditions

Acute Pain Management Hip Surgery

Interventions

Deep Posterior Gluteal Compartment BlockOTHER

Deep Posterior Gluteal Compartment Block will be performed under USG guidance before neuraxial anesthesia.

Suprainguinal fascia iliaca compartment blockOTHER

Suprainguinal fascia iliaca compartment block will be performed under USG guidance before neuraxial anesthesia.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Volunteering to participate in the study * Patients between the ages of 18-90 * ASA I, II, III * Patients whose surgery duration does not exceed 2 hours * Patients who will undergo surgery under spinal anesthesia Exclusion Criteria: * Patients who do not want to participate in the study/do not give consent * Patients with a condition that prevents regional anesthesia * Patients with cognitive dysfunction who are unable to evaluate the NRS score and who cannot use PCA (Patient Controlled Analgesia Device) * History of hypersensitivity or allergy to local anesthetics * Patients with psychiatric disorders and those using psychiatric medications * Presence of hematological disease * Presence of oncological disease * Patients with serious major organ failure * Presence of multiple fractures * Patients with alcohol or drug addiction * Patients who have used analgesic drugs up to 12 hours before surgery * ASA IV-V patients * Morbidly obese patients

Locations (1)

Samsun University, Samsun Training and Research Hospital

Samsun, Ilkadım, Turkey (Türkiye)

Outcomes

Primary Outcomes

Opioid consumption

In the postoperative period, patients will be given opioids according to their pain density with a patient-controlled device, and the daily Morphine consumption in Patient Controlled Analgesia device will be collected and compared between groups.

Time frame: 24 hours

Secondary Outcomes

Perioperative pain intensity

Changes in the Numerical Rating Scale (NRS) will be recorded at rest and during movement. The participant's baseline NRS will be recorded, followed by measurements before and after neuraxial positioning and up to 24 hours post-surgery. The NRS is a unidimensional measure of pain intensity in adults. It is a segmented numerical version of the Visual Analog Scale (VAS) where the participant selects a whole number (0-10) that best represents the intensity of their pain. The 11-point numerical scale ranges from '0' representing one end of the pain spectrum (e.g. 'no pain') to '10' representing the other end (e.g. 'worst imaginable pain').

Time frame: 24 hours

Quality of recovery 15 scale

Postoperative Quality of Recovery 15 in Turkish scale

Time frame: 24 hours after surgery

Quality of patient's position for neuraxial anesthesia

The position will be evaluated by anesthesiologist and characterized as "unsatisfactory", "satisfactory", "good" or "very good"

Time frame: up to ten minutes

Quadriceps weakness

Quadriceps strength will be graded according to a 3-point scale: normal strength = 0 point (extension against resistance); paresis = 1 point (extension against gravity but not against resistance); and paralysis = 2 points (no extension).

Time frame: 24th hours

Data from ClinicalTrials.gov

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