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Comparative Study Between Pericapsular Nerve Group Block (PENG) And Pericapsular Nerve Group (PENG) Block Combined With Lateral Femoral Cutaneous Nerve (LFCN) Block for Positioning Analgesia Prior to Spinal Anesthesia in Hip Fracture Patients

8. juli 2026 oppdatert av: Maha Salah, Ain Shams University
To evaluate and compare the effectiveness of the Pericapsular Nerve Group (PENG) block alone versus the PENG block combined with the Lateral Femoral Cutaneous Nerve (LFCN) block in providing adequate analgesia for patient positioning during spinal anesthesia in individuals undergoing surgery for hip fracture.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Hip fractures are common among adult patients and often necessitate urgent surgical intervention. Positioning these patients for spinal anesthesia in sitting position is often difficult due to intense pain from the fracture. PENG block is a novel regional technique that targets the articular branches of the femoral nerve, obturator nerve, and accessory obturator nerve, providing excellent anterior hip analgesia sparing the motor function. It is performed under ultrasound guidance and has shown promising results in perioperative pain management. By combining LFCN block with the PENG block, more complete sensory blockade may be achieved. The effectiveness of this combination has not yet been adequately studied, particularly regarding positioning for spinal anesthesia. Therefore, this trial aims to compare the analgesic efficacy of PENG block alone versus PENG +LFCN block in this specific context.

Studietype

Intervensjonell

Registrering (Antatt)

24

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Egypt
      • Cairo, Egypt
        • Rekruttering
        • Ain Shams University
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Age 18-70 years.
  • ASA I-II.
  • Confirmed primary unilateral hip fracture.
  • Scheduled for surgery under spinal anesthesia.
  • Patients able to provide informed consent.

Exclusion Criteria:

  • Allergy to local anesthetics.
  • Coagulopathy or on anticoagulant therapy.
  • Infection at injection site.
  • Pre-existing neurological deficits in the lower limbs.
  • Multiple trauma or polytrauma (If other injuries might interfere with positioning or pain scoring).
  • Previous surgery on the ipsilateral hip affecting anatomy or nerve distribution.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Støttende omsorg
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Group B (PENG block and LCFN block)
in addition to PENG block ( as described before), LFCN block is performed by using a linear array ultrasound probe a cross-sectional view of the LFCN was obtained by identifying the anterior superior iliac spine, then the probe is moved in a medial and caudal direction until the nerve was encountered. The needle was advanced to the LFCN under ultrasound guidance via a lateral to medial approach. Injection of 8ml of 0.25% of Bupivacaine (4 ml of Bupivacaine 0.5% is added to 4 ml of Lidocaine 2%)
Fremgangsmåte: PENG-blokk
Perikapsulær nervegruppeblokk
Legemiddel: bupivacaine 0.25%.
0.25% of Bupivacaine (Bupivacaine 0.5% is added to Lidocaine 2% in the same volume)
Legemiddel: Xylocaine 2 %
local infilteration at the insertion site
Fremgangsmåte: LCFN block
Lateral Femoral Cutaneous Nerve block
Aktiv komparator: group A (PENG BLOCK)
The patient is positioned supine and hip extended. 3 mL of 2% lidocaine is injected at the insertion site using a hyperechoic needle guided by ultrasound using a low-frequency probe. At the anterior superior iliac spine level, the probe is placed parallel to the inguinal fold, and scanning is performed with a gradual movement of the probe head. When the lower anterior inferior iliac spine is observed, the probe is rotated slightly median until a continuous hyperechoic shadow of the upper pubic ramus is visible. This maneuver help to identify the psoas muscle with a prominent tendon above the pubic ramus. The target is located in the plane between these 2 structures. The pubic ramus should be aligned in the center of the image to target the pubic ramus just inside the anterior inferior iliac spine. A 100-mm nerve block needle can be introduced, and 20 ml of 0.25% of Bupivacaine (10 ml of Bupivacaine 0.5% is added to 10ml of Lidocaine 2%) is administered
Fremgangsmåte: PENG-blokk
Perikapsulær nervegruppeblokk
Legemiddel: bupivacaine 0.25%.
0.25% of Bupivacaine (Bupivacaine 0.5% is added to Lidocaine 2% in the same volume)
Legemiddel: Xylocaine 2 %
local infilteration at the insertion site

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
To compare the time taken to achieve optimal positioning for spinal anesthesia in both groups
Tidsramme: from initiation of patient positioning until optimal positioning is achieved during the spinal anesthesia procedure
time taken in seconds for positioning for spinal anesthesia 15 minutes post- block
from initiation of patient positioning until optimal positioning is achieved during the spinal anesthesia procedure

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
To assess Numerical Rating Pain Score in both groups at 0,5,10 and 15 minutes post block
Tidsramme: at baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block
It refers to the common method used in healthcare where patients rate their pain on a scale from 0 to 10 (0 = No pain 10 = Worst pain imaginable).
at baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block
To assess patient satisfaction and comfort during positioning using Likert scale
Tidsramme: during patient positioning 15 minutes after completion of the block
5-Point scale (1=strongly disagree and 5=strongly agree). The participants measure it 15 minutes post- block during positioning for spinal anesthesia
during patient positioning 15 minutes after completion of the block
To monitor mean arterial blood pressure
Tidsramme: at baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block
Comparing mean arterial blood pressure between the 2 groups by millimeter of mercury (mmhg) at 0,5,10 and 15 minutes post-block.
at baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block
To monitor heart rate
Tidsramme: At baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block
Comparing the heart rate ( by beats per minute) in the 2 groups at 0,5,10 and 15 minutes post-block.
At baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block

Samarbeidspartnere og etterforskere

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Sponsor

Ain Shams University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

18. juni 2026

Primær fullføring (Antatt)

1. desember 2026

Studiet fullført (Antatt)

1. desember 2026

Datoer for studieregistrering

Først innsendt

18. juni 2026

Først innsendt som oppfylte QC-kriteriene

4. juli 2026

Først lagt ut (Faktiske)

7. juli 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

9. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

8. juli 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • FMASU MS 25 / 2026

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