Efficacy of Pericapsular Nerve Group Block
Study Comparing the Efficacy of Pericapsular Nerve Group (PENG) Block and Facia Iliaca Compartment Block (FICB) in Hip Fracture - A Prospective Randomised Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Hip fracture is a common orthopaedic problem especially in elderly population. The number of hip fractures each year is expected to double from 2.2 million in 2017 to 4.5 million in 2050. It is the commonest reason for elderly to require hospitalisation and emergency operation. Significant morbidities such as pulmonary embolism, pneumonia and bed sore can be resulted from immobility and pain. Hip fracture also contributes to post-operative mortality at a rate about 8% at 1 month and 30% at 1 year.
Fascia iliaca compartment block (FICB) and femoral nerve block are well-established technique as part of peri-operative multimodal analgesia for hip fractures. Cochrane review has shown peripheral nerve blocks including FICB, Femoral nerve block and 3-in-1 block could reduce both pain at 30 minute and opioid consumption compared with systemic analgesia. In particular, FICB is found to be superior to opioids for pain control on movement, preoperative analgesic consumption, time to first analgesic request, and time to perform spinal anaesthesia. However, literature suggests that the obturator nerve is not consistently covered.
The anterior hip capsule which contributes the major hip joint sensory innervation is supplied by femoral nerve (FN), obturator nerve (ON) and accessory obturator nerve (AON). As a result, a novel ultrasound guided regional technique, Pericapsular Nerve Group Block (PENG) was introduced in 2018, targeting the above 3 nerves. This is very important as the obturator nerve is also blocked with this technique. Case reports showed reduction in pain scores compared with baseline 30 minutes after block placement and no clinically evident quadriceps weakness was detected.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Timmy CW Chan, MBBS
- Phone Number: 22555679
- Email: timmychancw@gmail.com
Study Locations
-
-
-
Hong Kong, Hong Kong
- Recruiting
- Timmy Chan
-
Contact:
- Timmy Chan, MBBS
- Phone Number: 22555791
- Email: timmychancw@gmail.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- ASA I-II
- Age 18 or above
- Scheduled for hip fracture corrective surgery in Queen Mary Hospital
- Chinese patients
- Able to provide informed oral and written consent
- Abbreviated Mental Test (AMT) 7 or above
Exclusion Criteria:
- Patient refusal
- ASA III or above
- Allergy to local anaesthetics, opioids, paracetamol, NSAID including COX-2 inhibitors
- Operation delayed for more than 2 days on admission
- Pre-existing peripheral neuropathy or history of stroke
- Preoperative non-walker
- Pre-existing osteoarthritis of knee (KL grade 4)
- Multiple fractures (additional to hip fracture)
- Sepsis
- Impaired renal function (Defined as preoperative creatinine level >120 μmol or eGFR <50% of normal reference for their age group
- Patient with coagulopathy (Platelet < 100 or INR >1.5)
- Prior surgery at the inguinal or supra-inguinal area
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Pericapsular Nerve Group Block
30ml 0.3% Ropivacaine will be injected between psoas muscle and iliopubic eminence.
|
Nerve block targeting major hip joint sensory nerves.
|
|
Active Comparator: Fascia iliaca compartment block
30ml 0.3% Ropivacaine will be injected into fascia iliaca compartment.
|
Routine nerve block for hip fracture surgery.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pain score at rest on postoperative day 1
Time Frame: on postoperative day 1
|
Measure pain score at rest using numerical rating scale from 0 to 10, where 0 is no pain and 10 is the worst pain
|
on postoperative day 1
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Timmy CW Chan, MBBS, The University of Hong Kong
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UW21-382
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.