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Adequate pain control after total hip arthroplasty is crucial for early ambulation and patient satisfaction. However, there is no consensus about optimal pain control after post operation. In general, the periarticular multimodal durg injection block has been done for pain control in primary total hip arthroplasty. The pericapsular nerve group (PENG) block has been recently introduced a new technique for blockade of the articular branches of the femoral, obturator and accessory obturator nerves. PENG block is possible to provide sufficient analgesia and preserve lower limb muscle strength. The investigators will compare PENG and PMDI block with isolated PMDI block in patients undergoing total hip arthroplasty.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pericapsular nerve group(PENG) block combined with periarticular multimodal drug injection (PMDI) | Experimental | Participants receiving pericapsular nerve group(PENG) block combined with periarticular multimodal drug injection (PMDI) |
|
| isolated periarticular multimodal drug injection (PMDI) | Active Comparator | Arm Description: Participants receiving isolated periarticular multimodal drug injection (PMDI) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pericapsular nerve group(PENG) block combined with periarticular multimodal drug injection (PMDI) | Procedure | periarticular local anesthetic infiltration with 120 mg of ropivacaine, epinephrine 0.2 mg and 30 mg of ketorolac diluted with normal saline to a total volume of 40 mL. + PENG block with ropivacaine 40 mg and epinephrine 0.1 mg with normal saline to a total volume of 20 mL |
| Measure | Description | Time Frame |
|---|---|---|
| Numeric rating scale pain score | Pain intensity at rest evaluated by an 11-point numeric rating scale (NRS: 0 = no pain, 10 = worst imaginable pain) at 24 hours postoperatively | at 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Pain score measured at 6 hours postoperatively and 48 hours postoperatively | Pain intensity at rest evaluated by an 11-point numeric rating scale (NRS: 0 = no pain, 10 = worst imaginable pain) at 6 hours postoperatively and 48h postoperatively | Pain score measured at 6 hours postoperatively and 48 hours postoperatively |
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Inclusion Criteria:
1. Patients aged 19 years old or older, with American Society of Anesthesiologists Physical Status 1-3, and scheduled for elective unilateral total hip arthroplasty
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kwankyu Park | Contact | 82-2-2228-2183 | kkpark@yuhs.ac |
| Name | Affiliation | Role |
|---|---|---|
| Kwankyu Park | Department of orthopaedic surgery, Yonsei University College of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yonsei University Health System, Severance Hospital | Recruiting | Seoul | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40134083 | Derived | Cho HS, Lee BR, Kwon HM, Park JY, Ham HW, Lee WS, Park KK, Lee TS, Choi YS. Pericapsular Nerve Group Block with Periarticular Injection for Pain Management after Total Hip Arthroplasty: A Randomized Controlled Trial. Yonsei Med J. 2025 Apr;66(4):233-239. doi: 10.3349/ymj.2024.0098. |
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|
|
| isolated periarticular multimodal drug injection (PMDI) | Procedure | periarticular local anesthetic infiltration with 150 mg of ropivacaine, epinephrine 0.3 mg and 30 mg of ketorolac diluted with normal saline to a total volume of 50 mL |
|
|
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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