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PENG Block Vs. Intraoperative Local Anesthetic Infiltration for Total Hip Arthroplasty

Anesthesia

Currently, the analgesic standard of care for patients undergoing total hip arthroplasty (THA) at our centre is intraoperative infiltration with a solution of local anesthetic, morphine (opioid), and ketorolac (nonsteroidal anti-inflammatory drug - NSAID). If a patient has a contraindication for the use of an opioid or NSAIDs, this infiltration is performed with a plain local anesthetic. No blocks (numbing of certain nerves to prevent pain from occurring in that area) are performed for postoperative pain in these patients. The pericapsular nerve group (PENG) block is a recently described technique with limited data in the literature that has assessed the benefits of using this nerve block for THA procedures. The purpose of this study is to investigate if the ultrasound-guided PENG block can provide non-inferior postoperative analgesia compared to local intraoperative anesthetic infiltration (ILAI) with an associated cost benefit for patients undergoing THA.

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Participation Requirements

  • Sex:

    ALL

  • Eligible Ages:

    19 and up

Participation Criteria

Inclusion Criteria:

1. Adult patient (\>18 years old)
2. Undergoing THA with a direct lateral surgical approach (transgluteal approach)
3. Ability to provide verbal/written consent to participate in this trial

Exclusion Criteria:

1. Patient with any contraindication for spinal anesthesia
2. Patient with any contraindication for regional analgesia
3. Patient undergoing THA with a direct anterior surgical approach
4. Patients undergoing THA for hip revision
5. Patients undergoing THA under One Day Stay (ODS) admission
6. Patients that received opioids intrathecally
7. Patients having residual motor block six hours after the completion of the spinal anesthesia.
8. Patients with a history of regular opioid intake for more than three months
9. Patients incapable of performing knee extension of the same operative side
10. Pregnant patients

Study Location

London Health Sciences Centre
London Health Sciences Centre
London, Ontario
Canada

Contact Study Team

Primary Contact

Shalini Dhir

Study Sponsored By
London Health Sciences Centre Research Institute and Lawson Research Institute of St. Joseph's
Participants Required
More Information
Study ID: NCT05898581