Pericapsular Nerve Group With Lateral Femoral Cutaneous Nerve Block vs Suprainguinal Fascia Iliaca Block for Analgesia in Total Hip Arthroplasty: A Prospective Comparative Study

Hacettepe University48 enrolled

Overview

Prospective observational cohort comparing analgesic efficacy of suprainguinal fascia iliaca block (SFIB) vs pericapsular nerve group block combined with lateral femoral cutaneous nerve block (PENG+LFCN) in primary total hip arthroplasty under general anesthesia (n=48). Outcomes include VAS pain at rest and with movement at 3, 12, 24, 48 h; morphine use (0-3, 3-12, 12-24, 24-48 h; total 0-48 h); quadriceps strength at 6 and 24 h; physiotherapy participation at 24 and 48 h; and adverse events within 48 h.

Adults undergoing primary posterolateral THA under general anesthesia were included if they received either SFIB or PENG+LFCN. Pain (VAS at rest and with 45° passive flexion) was recorded at 3, 12, 24, and 48 h. Morphine via PCA was recorded for 0-3, 3-12, 12-24, and 24-48 h, with a 0-48 h total. Quadriceps strength (0-2 scale) was assessed at 6 and 24 h; physiotherapy participation at 24 and 48 h; opioid- or block-related adverse events through 48 h.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Coxarthrosis; Primary

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who are scheduled to undergo primary total hip arthroplasty with a diagnosis of coxarthosis Exclusion Criteria: * Patients who have a history of neuropathy, patients with renal and hepatic insufficiency, patients with known coagulopathy, patients with a history of allergy to local anesthetics, patients with a history of inguinal surgery on the same side and patients with impaired mental status

Locations (1)

Outcomes

Primary Outcomes

Visual Analogue Scale scores

Postoperative Visual Analogue Scale scores ( Minimum of 0 and maximum of 10 with higher scores indicative of more severe pain) will be measured at rest and 45 degrees passive flexion at 3, 12, 24 and 48th hours postoperatively

Time frame: In the 48 hours following surgery

Secondary Outcomes

Opioid consumption

Opioid consumption during 0-3,12-24, 24-48 hours and cumulative opioid consumption at 48h will be recorded following surgery

Time frame: In the 48 hours following surgery

Quadriceps weakness

Quadriceps weakness will be assessed at 6 and 24th hours after surgery. The patient will be asked to extend the knee with the hip flexed at 45 degrees. Quadriceps strength will be graded according to the following: Grade 0: No extension, Grade 1: Extension against gravity but not against resistance, Grade 2: Extension against gravity and resistance.

Time frame: In the 48 hours following surgery

Ability to perform physiotherapy

Ability to perform physiotherapy and whether the inability to perform physiotherapy was due to pain or motor weakness will be recorded by the physiotherapist at 24 and 48 hours after surgery

Time frame: In the 48 hours following surgery