PENG Block Combined to Wound Infiltration for Hip Replacement
Pericapsular Nerve Group (PENG) Block Combined to Wound Infiltration vs. Wound Infiltration Alone for Postoperative Analgesia After Total Hip Replacement: a Prospective Controlled Trial
This study analyze the effect of Pericapsular Nerve Group (PENG) Block combined to wound infiltration for analgesia after elective hip replacement.
Half of participants will receive a PENG Block combined with wound infiltration, while the other half will receive wound infiltration alone.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Roma, Italy
- Università Campus Biomedico
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Elective hip replacement surgery
- ASA physical status score < 4
Exclusion Criteria:
- Contraindications to regional anesthesia
- ASA physical status score ≥ 4
- Patient's refusal or inability to sing the informed consent
- Pre-operatively therapy with opioids
- Allergies to any drug provided by the study protocol
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: PENG BLOCK AND WOUND INFILTRATION
Participants receiving PENG block combined to wound infiltration
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After performing spinal anesthesia, PENG block with 20 mL of 0.375 % Ropivacaine will be executed as described by Giron-Arongo et al with a low frequency curvilinear probe.
A 22G 80 mm needle (Stimuplex Ultra 360, Braun ) will be used.
At the end of operation, the surgeon will perform wound infiltration with 20 mL of 0.375 % Ropivacaine.
|
|
Active Comparator: WOUND INFILTRATION
Participants receiving wound infiltration alone
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At the end of operation, the surgeon will perform wound infiltration with 20 mL of 0.375 % Ropivacaine.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Maximum Pain Score
Time Frame: 24 hours
|
A visual analog pain scale anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 [100-mm scale]) will be used to evaluate pain during 48 h after surgery
|
24 hours
|
|
Total opioids consumption
Time Frame: 48 hours
|
Total of Sublingual Sufentanil tablets released
|
48 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to first opioid
Time Frame: 48 hours
|
Time (hours) from the end of surgery to the first opioid administration
|
48 hours
|
|
Range of hip motion
Time Frame: 24 hours
|
Degrees of hip flexion
|
24 hours
|
|
Time to ambulation
Time Frame: 48 hours
|
Time until the patient is able to stand up and walk with or without assistive devices
|
48 hours
|
|
Quadriceps weakness
Time Frame: 48 hours
|
Presence of weakness of the quadriceps using a scale where 0= no effect; 1 = knee flexion possible but not hip flexion; 2 = absence of knee and hip flexion
|
48 hours
|
|
Incidence of block complications
Time Frame: 48 hours
|
Any complications or side effects of the blocks, such as local infection, intravascular injection of local anesthetics and immediate systemic toxicity.
|
48 hours
|
|
Opioids side effects
Time Frame: 48 hours
|
The presence or absence of opioids side effects such as drowsiness, desaturation, nausea and vomiting
|
48 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Giuseppe Pascarella, MD, University Hospital Campus Biomedico of Rome
Publications and helpful links
General Publications
- Giron-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular Nerve Group (PENG) Block for Hip Fracture. Reg Anesth Pain Med. 2018 Nov;43(8):859-863. doi: 10.1097/AAP.0000000000000847.
- Short AJ, Barnett JJG, Gofeld M, Baig E, Lam K, Agur AMR, Peng PWH. Anatomic Study of Innervation of the Anterior Hip Capsule: Implication for Image-Guided Intervention. Reg Anesth Pain Med. 2018 Feb;43(2):186-192. doi: 10.1097/AAP.0000000000000701.
- Pascarella G, Costa F, Del Buono R, Pulitanò R, Strumia A, Piliego C, De Quattro E, Cataldo R, Agrò FE, Carassiti M; collaborators. Impact of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial. Anaesthesia. 2021 Nov;76(11):1492-1498. doi: 10.1111/anae.15536. Epub 2021 Jul 1.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 29/20 PAR ComEt CBM
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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