Assessment of PENG Block as a Part of Multimodal Analgesia Following Hip Surgeries.

Effect of Ultrasound Guided Pericapsular Nerve Group (PENG) Block on Perioperative Pain Management in Patients Undergoing Hip Arthroplasty

to study the effect of Pericapsular nerve group (PENG) block as a part of multimodal analgesia regimen for hip arthroplasties

Study Overview

• Status: Active, not recruiting
• Conditions: Anesthesia
• Intervention / Treatment: Drug: Pericapsular nerve group (PENG) block; Other: Patients will receive only other multimodal analgesics including LCFN block via 10 ml of 0.25% bupivacaine.

Detailed Description

PENG block is a novel block described by Giron-Arango in 2018 to anesthesize the anterior hip capsule as it is supplied by branches from femoral, obturator and accessory obturator nerves, sparing motor function is an additional significance So currently the block is used to reduce post operative opioid consumption, delay time rescue analgesia, facilitate positioning for spinal anesthesia for hip surgeries and to accelerate mobility and so hospital discharge saving this vulnerable group of patient from any hospital acquired pneumonia, decreasing hospital stays, and improving recovery times would provide valuable insights into its cost-effectiveness and long-term benefits for healthcare system Our primary outcome to be studied is pain assessment via Numer Rating Scale over 24 hours postoperatively, in addition to to secondary outcomes including the aforementioned advantages.

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo
    • Abbasia, Cairo, Egypt, 11517
      • Faculty of medicine, Ain Shams university

Participation Criteria

Eligibility Criteria

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

Description

Inclusion criteria:

• Age group: 18 years and older.
• ASA classification I to III.
• BMI : 18-35 .
• Gender: both sex

Exclusion criteria:

• Patient refusal.
• Patients on long-term pain medications.
• History of allergic reactions to local anesthetics
• Patients who had mental illness or uncooperative patients.
• BMI > 35 .
• Patients having coagulopathies or on anticoagulant or antiplatelet therapy.
• Severe cardiopulmonary disease
• ASA IV or more
• Diabetic or other neuropathies

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: PENG block group (25 particiants); For postoperative pain management, all patients of this arm will receive 20 ml of 0.25% bupivcacaine according to the technique described by Giron-Arango. In addition, multimodal analgesia will be given including IV paracetamol 1000 mg BID and oral celecoxib tablet 100 mg BID. Also if needed nalbuphine 5 mg IV will be given as demand dose and when the NRS pain score was equal to or greater than 4 points.	Drug: Pericapsular nerve group (PENG) block; As a part of multimodal analgesia patients will receive 20 ml of 0.25% bupivcacaine according to the technique described by Giron-Arango. All patients will receive the same analgesic protocol, which included IV paracetamol 1000 mg BID and NSAIDs if no contra-indication; PO celecoxib 100 mg BID. Also if needed nalbuphine 5 mg IV will be given as bolus demand dose and when the NRS pain score was equal to or greater than 4 points.
Experimental: Group C: control group (25 participants); Patients will receive only other multimodal analgesics	Other: Patients will receive only other multimodal analgesics including LCFN block via 10 ml of 0.25% bupivacaine.; Patients will receive only other multimodal analgesics including LCFN block via 10 ml of 0.25% bupivacaine.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain score: pain assessment using a Numeric Rating System (NRS) immediately in the postoperative period.	Pain score: pain intensity will be evaluated using a Numeric Rating System (NRS) immediately in the postoperative period, every 2 hours during the first 6 hours and then every 6 hours till 24 hours postoperatively. Scores ranging from 0 to 10, with 0 indicating the absence of pain and 10 indicating the worst possible pain.	24 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rescue analgesia timing and opioid consumption over 24 hours	Time to first opioid demand and total opioid consumed by each patient individually over 24 hours.	24 hours

Collaborators and Investigators

• Sponsor: Ain Shams University

Study record dates

Study Major Dates

• Study Start (Actual): June 27, 2024
• Primary Completion (Estimated): June 1, 2025
• Study Completion (Estimated): June 1, 2025

Study Registration Dates

• First Submitted: November 28, 2024
• First Submitted That Met QC Criteria: April 4, 2025
• First Posted (Actual): April 8, 2025

Study Record Updates

• Last Update Posted (Actual): April 8, 2025
• Last Update Submitted That Met QC Criteria: April 4, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Peripheral Nervous System Agents; Anesthetics, Local; Anesthetics; Central Nervous System Depressants; Sensory System Agents; Bupivacaine; Analgesics
• Other Study ID Numbers: FMASU MS428/2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No