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Patients With Acute Hip Fractures Will Receive Either the PENG Block or no Block Respectively. (PENGBlock)

2. august 2021 opdateret af: Singapore General Hospital

Evaluation of the PENG Block vs Placebo for Preoperative Pain Control in Hip Fractures in the Elderly - a Double-blinded Randomised Controlled Trial

Hip fracture pain is often severe and traditionally managed by systemic opioids which have increased risk of side effects in frail elderly patients. Inadequately controlled pain may lead to delirium which increases mortality and morbidity. The overall aim of this RCT is to investigate the potential for improved pain relief accomplished by the addition of the PENG block to current standard practice of pre-operative analgesia (systemic morphine), compared to the control group, which involves no block (operator will still go through the motion as if performing a block) plus standard pre-operative analgesia.

The investigator hypothesize that the addition of a single shot PENG block at the side of hip fracture in addition to traditional systemic morphine provides good preoperative pain relief on movement and reduces the need for breakthrough opioid requirements. The investigator hypothesize that the interventional group dynamic pain score assessed at 30 minutes after the block compared to control group dynamic pain score at 30 minutes after the "block" will be at least a 3 point difference between the 2 groups .

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Specific Aim1: To determine difference in pain scores on movement (dynamic pain scores) in patients who receive the PENG block in the intervention group compared to no block in the control group at 30 minutes after performance of the block.

Specific Aim2: To determine if there is any difference in pain at rest between the intervention group and the control group, and if so, the magnitude of the difference in pain scores.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

60

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

60 år til 100 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Age 60 years old and above
  2. Provided consent for the study
  3. Patients with solitary hip fracture (no other fracture) - intracapsular neck of femur fracture, intertrochanteric fracture
  4. Either awaiting hip fracture surgery or no plans for hip fracture surgery within the next 24 hours

Exclusion Criteria:

  1. Patients with cognitive impairment or inability to give consent, or refusal to give consent
  2. Multiple fracture cases
  3. Peri-prosthetic fractures and revisions
  4. Subclinical vertebral fractures
  5. Hip fractures due to major accidents such as road traffic accidents, fall from height or more than 2 meters
  6. Multiple trauma
  7. Pathological fractures secondary to metastases

  8. Patients with contraindications to block performance

    • Coagulopathy as demonstrated by PT/PTT/INR
    • On antiplatelets or anticoagulation
    • Infection/ compromised skin integrity at site of block performance
    • Allergy to local anaesthetics and opioids

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Placebo komparator: Control
Only standard care
Medicin: Placebo
Standard pleje
Andre navne:
  • Standard pleje
Eksperimentel: Intervention group
The PENG block was performed for intervention group with local anaesthetic solution composed of 20 ml of ropivacaine 0.5%.
Medicin: Ropivacaine 0.5% Injectable Solution
Local anaesthetic solution composed of ropivacaine 0.5%(intervention group)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Dynamic pain scores (Numerical pain score (NRS) at 15 degrees leg lift)
Tidsramme: 30 minutes after receiving intervention
The difference in dynamic pain scores (NRS at 15 degrees leg lift) at 30 minutes post block performance in the intervention group vs the control group. Assessment of the dynamic pain score is done prior to discharge from recovery at SGH Pain Management Centre.
30 minutes after receiving intervention

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pain scores (NRS) at rest (static pain) and on movement (dynamic pain)
Tidsramme: Up to 24 hours from performance of block
It is measured at Baseline, Immediately after performance of block, 30 minutes after the lock in recovery At 60 minutes, 180 minutes and 24 hours post block in the ward
Up to 24 hours from performance of block
Pain scores collected to estimate the onset and duration of block Pain scores to estimate the onset and duration of block
Tidsramme: Up to 24 hours from performance of block
Taking the recorded time taken for the pain relieve to estimate onset time using models
Up to 24 hours from performance of block
Total opioid use over 24 hours as a surrogate measure
Tidsramme: Up to 24 hours from performance of block

Using the data recorded for :

Oral morphine use Intravenous morphine use for patients on PCA Doses of opioid use will be converted to morphine milligram equivalent daily dose (MEDD) for standardized comparison.
Up to 24 hours from performance of block

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Singapore General Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Hjælpsomme links

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

24. maj 2021

Primær færdiggørelse (Forventet)

31. maj 2022

Studieafslutning (Forventet)

31. december 2022

Datoer for studieregistrering

Først indsendt

10. maj 2021

Først indsendt, der opfyldte QC-kriterier

2. august 2021

Først opslået (Faktiske)

9. august 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

9. august 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. august 2021

Sidst verificeret

1. august 2021

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2 (Anden identifikator: Instituto Cardiovascular de Buenos Aires)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

Uafklaret

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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