Posterior Pericapsular Deep Gluteal Block Combined With Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve Blocks for Hip Surgery Analgesia

Efficacy of Combining Ultrasound-guided Posterior Pericapsular Deep Gluteal Block to Both Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve Blocks for Postoperative Analgesia in Orthopedic Hip Surgeries

This study aims to investigate the efficacy of adding a Posterior Pericapsular Deep gluteal block to two other standard nerve blocks-the Pericapsular Nerve Group block and the Lateral Femoral Cutaneous Nerve block-for patients undergoing orthopedic hip surgery. While standard blocks target the front of the hip, many patients still feel pain in the back (posterior) of the joint. Researchers will compare two groups of patients to see if this triple-block combination provides better pain relief and reduces the need for rescue opioid medications in the 24 hours following surgery.

Patients undergoing elective orthopedic hip surgery will be randomly assigned to one of two groups. Both groups will receive general anesthesia followed by ultrasound-guided nerve blocks. Group 1 will receive a Pericapsular Nerve Group block and a Lateral Femoral Cutaneous Nerve block using 0.25% bupivacaine. Group 2 will receive these same two blocks plus an additional Posterior Pericapsular Deep gluteal block, also using 0.25% bupivacaine.

The primary goal is to evaluate postoperative pain using the Numerical Rating Scale at 6, 12, and 24 hours for both static and dynamic states. Secondary objectives include assessing quadriceps muscle strength using the Lovett Grading Method, measuring total rescue analgesia (nalbuphine) consumption, and monitoring for any complications or differences in length of hospital stay.

Inclusion Criteria:

• Age greater than or equal to 18 years.
• Both genders included.
• American Society of Anesthesiologists (ASA) physical status classification I-III.
• Undergoing elective orthopedic hip surgery.
• Provision of written informed consent.

Exclusion Criteria:

• Patient refusal of procedure or participation.
• American Society of Anesthesiologists (ASA) physical status classification IV.
• Allergy to any of the drugs used in the study.
• Local skin infection at the injection site.
• Coagulation disorder.
• History of cardiac arrhythmia, seizures, or increased intracranial tension.
• Alcohol or drug abuse, or psychiatric disease.
• History of chronic pain.