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Effect of PENG block and ESPB on pain management, and NLR and PLR following knee arthroplasty
Hip arthroplasty is one of the most common orthopedic procedures, especially in elderly patients, due to the deformation of joints. Patients may complain of severe pain due to surgical trauma and prosthesis. Regional anesthesia methods may be performed to reduce the inflammatory response, opioid consumption, and opioid-related side effects.
In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasized. However, very few studies have evaluated the effect of various methods of anesthesia on the NLR.
This is the first study to investigate the effect of regional anesthesia on the NLR and PLR in patients undergoing hip replacement surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PENG Block group | Active Comparator | ultrasound guided PENG block - 20ml 0,2% ropivacaine |
|
| ESPB group | Active Comparator | ultrasound guided erector spinae plane block - 20ml 0,2% ropivacaine |
|
| Control group | Active Comparator | Only spinal anesthesia - No peripheral nerve block |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine 0.2% Injectable Solution Erector Spinae Plane Block | Drug | ultrasound guided ESPB - L4 level, unilateral |
|
| Measure | Description | Time Frame |
|---|---|---|
| Opioid consumption | Total opiate consumption after surgery | 48 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| first need of opiate | Time after surgery when the patient needs opiate for the first time | 48 hours after procedure |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Małgorzata Domagalska, Ph.D. | Poznań University of Medical Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Poznan University of Medical Sciences | Poznan | Poznań | 61-701 | Poland |
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| ID | Term |
|---|---|
| D015207 | Osteoarthritis, Hip |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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| Ropivacaine 0.2% Injectable Solution - PENG block | Drug | ultrasound guided PENG block |
|
|
| Control Test | Drug | Only spinal anesthesia |
|
|
| 4 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 8 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 12 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 18 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 24 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 36 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 48 hours after surgery |
| Neutrophil-to-lymphocyte ratio | Neutrophil-to-lymphocyte ratio | 24 hours after surgery |
| Neutrophil-to-lymphocyte ratio | Neutrophil-to-lymphocyte ratio | 48 hours after surgery |
| Platelet-to-lymphocyte ratio | Platelet-to-lymphocyte ratio | 24 hours after surgery |
| Platelet-to-lymphocyte ratio | Platelet-to-lymphocyte ratio | 48 hours after surgery |
| Quadriceps muscle strength assessed using medical research council scale [range 0:5] | Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating | Postoperative 24 hours period |
| D012216 |
| Rheumatic Diseases |
| D000588 |
| Amines |