The Ultrasound Guided Pericapsular Nerve Group and Anterior Quadratus Lumborum Blocks in Hip Replacement Surgeries

Comparison Between the Ultrasound Guided Pericapsular Nerve Group Block and Anterior Quadratus Lumborum Block in Elderly Patients Undergoing Total Hip Replacement Surgeries: A Randomized Controlled Clinical Trial

The investigators hypothesis that PENG block will produce effective opioid sparing analgesia with enhanced motor recovery more than AQLB in elderly patients undergoing total hip replacement surgeries

Aim of the work:

The aim of this study is to compare analgesic efficacy and motor recovery of the ultrasound guided anterior quadratus lumborum block and the pericapsular nerve group block

Statistical Analysis:

Data will be coded and entered using the statistical package SPSS version 22. Categorical data will be expressed frequency and proportion and will be compared by Chi2. Numerical data will be summarized using mean and standard deviation. Comparisons between groups for normally distributed data will be done using analysis of variance (ANOVA), while for non-normally distributed numeric variable will be done by Krauskal Wallis test. P value less than or equal to 0.05 will be considered statistically significant. All test will be two tailed

Inclusion Criteria:

• Both genders
• Type of surgery; unilateral elective total hip replacement.
• Physical status ASA I- III
• Age ≥ 65 Years.
• Body mass index (BMI): > 20 kg/m2 and < 35 kg/m2.
• Traumatic fracture hip through anterolateral approach.

Exclusion Criteria:

• Patient refusal.
• Patients with known sensitivity or contraindication to drugs used in the study (local anesthetics & opioids).
• History of psychological disorders and/or chronic pain.
• Pre- existing peripheral neuropathies
• Coagulopathy.
• Infection of the skin at the site of needle puncture area.
• Active cardiac condition (unstable coronary syndromes, significant arrhythmias, severe valvular disease).
• Acute respiratory disease (active chest infection, respiratory failure).
• Advanced liver disease (increased liver enzymes >3 folds) or severe kidney disease (creatinine >2).
• long operative time more than 3 hours.