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NCT Number: NCT05654519

Comparison of Pericapsular Nerve Group Block and Quadratus Lumborum Block

Adequate pain management following total hip arthroplasty (THA) is a key component for patient satisfaction and early ambulation. However, due to the complexity of the innervation of the hip joint, the most appropriate anaesthetic and analgesic technique for THA remains unclear. A femoral nerve block is commonly performed and well established but is associated with motor weakness. Recently, the pericapsular nerve group (PENG) block has been introduced as an effective choice which targets the articular branches of the hip. The quadratus lumborum block (QLB) is a relatively new regional block that has been reported to provide effective analgesia for THA.

The main objective of this study is to compare the effectiveness of the ultrasound-guided PENG block technique compared to QLB block in terms of efficacy of pain control and the safety profile after total hip arthroplasty under spinal anesthesia.

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Key information

Conditions

Total Hip Surgery Pericapsular Nerve Quadratus Lumborum

Age range

40 year–85 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Alper KILICASLAN

Konya, Turkey (Türkiye)

About this study

The patients will be randomly classified into two equal groups (40 patients each). Group allocation will be done by computer generated random numbers and closed opaque sealed envelopes. The study will be designed to be double blind as all patients and outcomes assessor will be blinded to group assignment.

Patients will be randomized to one of three equal groups:

Group I (n= 40 patients): Patients in this group will receive an ipsilateral single shot of QLB (30 ml of plain bupivacaine 0.25%) after surgery using ultrasonographic guidance.

Group II(n= 40 patients): patients in this group will receive an ipsilateral single-shot of PENG block (25 ml of plain bupivacaine 0.25%) and LFCN block (5 ml of plain bupivacaine 0.25%) after surgery using ultrasonographic guidance.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Physical status according to American Society of Anesthesiologists (ASA ) I-III

Exclusion criteria

  • Younger than 40 years old and older than 85
  • Patients undergoing general anesthesia
  • Allergy or intolerance to one of the study medications
  • Infection of the skin at the site of the needle puncture,
  • Patients who do not accept the procedure
  • History of bleeding diathesis
  • ASA IV,
  • Chronic gabapentin/pregabalin,opioid use
  • Hepatic or renal insufficiency
  • Previous operation on the same hip
  • BMI >40

Treatment and study plan

PENG/LFCN and QL Blocks

Drug

Bupivacaine 0.25% injection

Primary outcomes

  1. Pain scores

    Time frame: Changes from baseline opioid consumption at postoperative 0, 2, 6, 12 and 24 hours

    Numerical Rating Scale-NRS (0 = no pain and 10 = worst imaginable painranged from 0 to 10)

  2. Opioid consumption

    Time frame: Changes from baseline opioid consumption at postoperative 0, 2, 6, 12 and 24 hours

    Mean opioid consumption in morphine equivalents

Secondary outcomes

  1. Quadriceps muscle strength

    Time frame: Postoperative 24 hours period

    Quadriceps motor function will be tested with the patient supine and with the hip and knee flexed at 45º and 90º, respectively

  2. Presence of postoperative nausea, vomiting, pruritus, urinary retention, respiratory depression

    Time frame: Postoperative 24 hours period

    Presence of postoperative nausea, vomiting, pruritus, urinary retention, respiratory depressio

  3. Patient satisfaction

    Time frame: Postoperative 24 hours period

    Patients asked whether they would choose the same anaesthetic management in a future operation: Yes/No

Sponsors and collaborators

Lead sponsor

Konya Necmettin Erbakan Üniversitesi

Other

Registry information

Official study title

Comparison of Pericapsular Nerve Group Block with Lateral Femoral Cutaneous Nerve Block and Quadratus Lumborum Block for Total Hip Arthroplasty

Important dates

Study start
2022
Primary completion
2023
Study completion
2023
First posted
Dec 16, 2022
Registry last updated
Dec 20, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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