Postoperative Analgesia After Total Hip Arthroplasty: Comparative Evaluation of Pericapsular Nerve Group Versus Fascia Iliaca Compartment Block

Postoperative Analgesia After Total Hip Arthroplasty: Comparative Evaluation of Pericapsular Nerve Group Versus Fascia Iliaca Compartment Block in a Randomized Controlled Trial

The aim of this study is to compare the effectiveness of pericapsular nerve group (PENG) block versus fascia iliaca compartment block (FICB) for postoperative pain relief following total hip arthroplasty (THA).

Study Overview

• Status: Completed
• Conditions: Total Hip Arthroplasty; Postoperative Analgesia; Pericapsular Nerve Group Block; Fascia Iliaca Compartment Block
• Intervention / Treatment: Other: Fascia iliaca compartment block; Other: Pericapsular nerve group block

Detailed Description

Total hip arthroplasty is a widely used surgical treatment intervention for treating hip conditions such as femur neck fractures and advanced hip osteoarthritis.

Hip fractures are quite common, regardless of the age of the population (young or old), and they are extremely painful. A hip fracture is a serious injury with potentially life-threatening complications, and it is a common orthopedic emergency in elderly individuals. Early surgery within 48 hours of a fracture has been found to lower mortality and complication rates.

The pericapsular nerve group block is a novel regional analgesia technique to decrease pain after total hip arthroplasty (THA) while preserving the motor function. The local anaesthetic is deposited using this method in the fascial plane between the psoas muscle and the superior pubic ramus, which aims sensory branches of the obturator, accessory obturator, and femoral nerves in the anterior capsule of the hip.

Fascia iliaca compartment block, for procedures on the femur and hip joint, is still a well-liked regional anaesthetic technique. Studies have found that FICB prevents complications by anaesthetizing the femoral nerve far from critical neurovascular structures while still giving enough analgesia.

Both blocks could be used to effectively reduce pain intensity up to 24 hours, total opioid consumption, and length of hospital stay in THA patients.

• Study Type: Interventional
• Enrollment (Actual): 68
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 11588
    • Ain shams university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age from 18 to 80 years.
• Both sexes.
• American Society of Anaesthesiologists (ASA) Physical Status II-III.
• Scheduled for Total hip arthroplasty (THA) under spinal anesthesia.

Exclusion Criteria:

• Patients' refusal
• Contraindications to spinal anesthesia or nerve blocks.
• History of allergy to the medications used in the study.
• Pregnancy.
• Significant cognitive impairment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group A; Patients received an ultrasound-guided supra-inguinal fascia iliaca compartment block.	Other: Fascia iliaca compartment block; Patients received an ultrasound-guided supra-inguinal fascia iliaca compartment block.
Active Comparator: Group B; Patients received an ultrasound-guided pericapsular nerve group (PENG) block.	Other: Pericapsular nerve group block; Patients received an ultrasound-guided pericapsular nerve group (PENG) block.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Degree of pain	Degree of pain was assessed using the Visual Analogue Scale (VAS). VAS is ranging from 0 to 10, where 0 is no pain and 10 is maximum pain. VAS was recorded at 0, 2, 4, 6, 12, 18, and 24 hours postoperatively.	24 hours postoperatively
Total amount of nalbuphine consumption	If the postoperative Visual Analogue Scale (VAS) was greater than 3, an intravenous dose of 5 mg Nalbuphine diluted in 5 mL of saline was administered as needed.	24 hours postoperatively
Number of cases needing rescue doses	The number of cases needing rescue doses was recorded.	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative ambulation	Time from completion of surgery to first assisted standing and walking ≥2 meters was recorded as the ambulation time.	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Ain Shams University
• Investigators: Principal Investigator: Diaaeldin DA Aboelnile, MD, Lecturer, Faculty of medicine, Ain Shams university

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2023
• Primary Completion (Actual): September 1, 2024
• Study Completion (Actual): September 1, 2024

Study Registration Dates

• First Submitted: July 12, 2023
• First Submitted That Met QC Criteria: August 15, 2023
• First Posted (Actual): August 22, 2023

Study Record Updates

• Last Update Posted (Actual): August 13, 2026
• Last Update Submitted That Met QC Criteria: August 11, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: FMASU MD76/2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No