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Effect of PENG block on NLR and PLR following hip arthroplasty
The NLR is a sensitive indicator of inflammation confirmed in numerous studies and has a predictive and prognostic value. NLR is a cheap, simple, fast-acting, readily available stress and inflammation parameter with high sensitivity and low specificity. Dynamic changes in the NLR precede the clinical state by several hours and may alert clinicians to the ongoing pathological process early. NLR is a new promising marker of cellular immune activation, an important indicator of stress and systemic inflammation. It opens a new dimension for clinical medicine, enabling a better understanding of the biology of inflammation, the linkage and antagonism between innate and adaptive immunity, and their clinical consequences for health and disease.
NLR is affected not only by surgical trauma but also by the method of anesthesia. In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasized. However, there have been very few studies evaluating the effect of various methods of anesthesia on the NLR.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sham blocks | Placebo Comparator | PENG block with 20ml of 0.9% sodium chloride |
|
| PENG block | Active Comparator | PENG block with 20ml 0f 0.2% ropivacaine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 0.9% Sodium Chloride Injection | Drug | After spinal anesthesia, the ultrasound-guided PENG block will be performed with 20ml of 0.9% sodium chloride |
|
| Measure | Description | Time Frame |
|---|---|---|
| Neutrophil-to-lymphocyte ratio | Neutrophil to lymphocyte ratio (NLR) is used as a marker of subclinical inflammation. It is calculated by dividing the number of neutrophils by number of lymphocytes, usually from peripheral blood sample, but sometimes also from cells that infiltrate tissue, such as tumor. | 12 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| PLR | Platelet-to-lymphocyte ratio | 12 hours after surgery |
| PLR | Platelet-to-lymphocyte ratio | 24 hours after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Malgorzata Reysner, M.D. Ph.D. | Poznan University of Medical Sciences | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Poznan University of Medical Sciences | Poznan | 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 |
|---|---|
| D012965 | Sodium Chloride |
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
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| Ropivacaine 0.2% Injectable Solution | Drug | After spinal anesthesia, the ultrasound-guided PENG block will be performed with 20 ml of 0.2% ropivacaine |
|
| PLR | Platelet-to-lymphocyte ratio | 48 hours after surgery |
| NLR | Neutrophil-to-lymphocyte ratio | 24 hours after surgery |
| NLR | Neutrophil-to-lymphocyte ratio | 48 hours after surgery |
| first need of opiate | Time after surgery when the patient needs opiate for the first time | 48 hours after procedure |
| Opioid Consumption | Total opiate consumption after surgery | 48 hours after surgery |
| Pain score | NRS (Numerical Rating Scale) - ranging from 0 to 10, where 0 represents "no pain" and 10 represents the "worst pain imaginable" | 4 hours after surgery |
| Pain score | NRS (Numerical Rating Scale) - ranging from 0 to 10, where 0 represents "no pain" and 10 represents the "worst pain imaginable" | 8 hours after surgery |
| Pain score | NRS (Numerical Rating Scale) - ranging from 0 to 10, where 0 represents "no pain" and 10 represents the "worst pain imaginable" | 12 hours after surgery |
| Pain score | NRS (Numerical Rating Scale) - ranging from 0 to 10, where 0 represents "no pain" and 10 represents the "worst pain imaginable" | 24 hours after surgery |
| D012216 |
| Rheumatic Diseases |
| D017670 |
| Sodium Compounds |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |