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This study analyze the effect of Pericapsular Nerve Group (PENG) Block combined to wound infiltration for analgesia after elective hip replacement.
Half of participants will receive a PENG Block combined with wound infiltration, while the other half will receive wound infiltration alone.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PENG BLOCK AND WOUND INFILTRATION | Experimental | Participants receiving PENG block combined to wound infiltration |
|
| WOUND INFILTRATION | Active Comparator | Participants receiving wound infiltration alone |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PENG block | Procedure | After performing spinal anesthesia, PENG block with 20 mL of 0.375 % Ropivacaine will be executed as described by Giron-Arongo et al with a low frequency curvilinear probe. A 22G 80 mm needle (Stimuplex Ultra 360, Braun ) will be used. |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Pain Score | A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 [100-mm scale]) will be used to evaluate pain during 48 h after surgery | 24 hours |
| Total opioids consumption | Total of Sublingual Sufentanil tablets released | 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Time to first opioid | Time (hours) from the end of surgery to the first opioid administration | 48 hours |
| Range of hip motion | Degrees of hip flexion |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Giuseppe Pascarella, MD | University Hospital Campus Biomedico of Rome | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Università Campus Biomedico | Roma | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29140962 | Background | Short AJ, Barnett JJG, Gofeld M, Baig E, Lam K, Agur AMR, Peng PWH. Anatomic Study of Innervation of the Anterior Hip Capsule: Implication for Image-Guided Intervention. Reg Anesth Pain Med. 2018 Feb;43(2):186-192. doi: 10.1097/AAP.0000000000000701. | |
| 30063657 | Result | Giron-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular Nerve Group (PENG) Block for Hip Fracture. Reg Anesth Pain Med. 2018 Nov;43(8):859-863. doi: 10.1097/AAP.0000000000000847. |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D000377 | Agnosia |
| D059787 | Acute Pain |
| D010146 | Pain |
| D011183 | Postoperative Complications |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| Wound Infiltration | Procedure | At the end of operation, the surgeon will perform wound infiltration with 20 mL of 0.375 % Ropivacaine. |
|
| 24 hours |
| Time to ambulation | Time until the patient is able to stand up and walk with or without assistive devices | 48 hours |
| Quadriceps weakness | Presence of weakness of the quadriceps using a scale where 0= no effect; 1 = knee flexion possible but not hip flexion; 2 = absence of knee and hip flexion | 48 hours |
| Incidence of block complications | Any complications or side effects of the blocks, such as local infection, intravascular injection of local anesthetics and immediate systemic toxicity. | 48 hours |
| Opioids side effects | The presence or absence of opioids side effects such as drowsiness, desaturation, nausea and vomiting | 48 hours |
| 34196965 | Derived | Pascarella G, Costa F, Del Buono R, Pulitano R, Strumia A, Piliego C, De Quattro E, Cataldo R, Agro FE, Carassiti M; collaborators. Impact of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial. Anaesthesia. 2021 Nov;76(11):1492-1498. doi: 10.1111/anae.15536. Epub 2021 Jul 1. |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009422 | Nervous System Diseases |