Continuous Pericapsular Nerve Group Block in Hip Fracture Patients
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ClinicalTrials.gov Identifier: NCT03885739 |
Recruitment Status :
Completed
First Posted : March 22, 2019
Last Update Posted : May 30, 2019
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Background- Despite clinical guidelines favoring surgical repair of hip fracture (HF) within 48 hours of injury, patients may wait considerable periods of time for their turn in the operating room. In this context, continuous nerve blocks are an attractive alternative for pain management. However, the ideal block technique is not yet defined. Recently a new ultrasound-guided approach for selective blockade of the articular branches to the hip, the PENG (Pericapsular Nerve Group) block, has been proposed with potentials advantages for perioperative hip fracture analgesia.
Objective- To describe the analgesic efficacy and feasibility of continuous Pericapsular Nerve Group block (CPENGB) in patients with HF.
Design-Interventional study. Setting-Academic Level 3 center. Methods- Two experienced anesthesiologist completed 15 sonographically guided Pericapsular Nerve Group (PENG) injections and catheter insertion in patients with severe pain awaiting HF surgery. Each injection consisted of 20 mL of local anesthetics followed by a 0.1% bupivacaine continuous infusion at a constant rate of 8 ml per hour. Pain at rest and on 15° leg lift of the fractured leg were assessed before procedure, 10 and 30 minutes after block performance, and each 24 hours until surgery. A reduction of severe or moderate dynamic pain to mild pain or no pain, and a pain relief of 2 (moderate) were clinically significant findings. To determine feasibility time and number of attempts to perform the procedure were measured.
Condition or disease | Intervention/treatment | Phase |
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Hip Fractures | Other: Continuous Pericapsular Nerve Group block | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 15 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Intervention Model Description: | interventional study. |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Continuous Pericapsular Nerve Group Block in Hip Fracture Patients |
Actual Study Start Date : | October 1, 2018 |
Actual Primary Completion Date : | January 15, 2019 |
Actual Study Completion Date : | January 15, 2019 |

Arm | Intervention/treatment |
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Patients with hip fracture
15 consecutive HF patients who were admitted to a single level 3 center and who report severe pain despite a standardized analgesia protocol. Patients were assessed by the Pain Service as part of a multidisciplinary care pathway and a Continuous Pericapsular Nerve Group blocks was offered as a component of a multimodal analgesic regimen.
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Other: Continuous Pericapsular Nerve Group block
Continuous Pericapsular Nerve Group block to standardize the approach. Injections were performed using a curvilinear low-frequency ultrasound probe (3.5- to 5-MHz). The lateral border of iliopsoas tendon in an oblique axial plane at level of iliopectineal eminence provides target for needle placement. Toggling the transducer was necessary to optimize visualization of the iliopsoas tendon secondary to anisotropy. Injections were performed using an 18-gauge Tuohy needle under sterile conditions. Then, 10 mL 0.25% bupivacaine was administered and a 20-G polyamide catheter (connect to a filter) was advanced into the space. The end point of the catheter placement was the direct visualization of microbubbles in a peritendinous distribution using a bolus of agitated saline applied through threaded catheter connected to not purged filter. After catheter placement patients received a 0.1% bupivacaine continuous infusion at a constant rate. |
- Verbal Rating Scale with four response categories, VRS-4 [ Time Frame: Before procedure ]Patients were asked to rate the severity of their pain on a 4-point numeric rating scale VRS-4: 1) no pain, 2) mild pain, 3) moderate pain, and 4) severe pain or ''worst pain imaginable''. Pain at rest and on movement (pain on 15° leg lift of the fractured leg)
- Verbal Rating Scale with four response categories, VRS-4 [ Time Frame: 10 minutes after procedure ]Patients were asked to rate the severity of their pain on a 4-point numeric rating scale VRS-4: 1) no pain, 2) mild pain, 3) moderate pain, and 4) severe pain or ''worst pain imaginable''. Pain at rest and on movement (pain on 15° leg lift of the fractured leg)
- Verbal Rating Scale with four response categories, VRS-4 [ Time Frame: 30 minutes after procedure ]Patients were asked to rate the severity of their pain on a 4-point numeric rating scale VRS-4: 1) no pain, 2) mild pain, 3) moderate pain, and 4) severe pain or ''worst pain imaginable''. Pain at rest and on movement (pain on 15° leg lift of the fractured leg)
- Verbal Rating Scale with four response categories, VRS-4 [ Time Frame: 24 hours after procedure ]Patients were asked to rate the severity of their pain on a 4-point numeric rating scale VRS-4: 1) no pain, 2) mild pain, 3) moderate pain, and 4) severe pain or ''worst pain imaginable''. Pain at rest and on movement (pain on 15° leg lift of the fractured leg)
- Verbal Rating Scale with four response categories, VRS-4 [ Time Frame: 48 hours after procedure ]Patients were asked to rate the severity of their pain on a 4-point numeric rating scale VRS-4: 1) no pain, 2) mild pain, 3) moderate pain, and 4) severe pain or ''worst pain imaginable''. Pain at rest and on movement (pain on 15° leg lift of the fractured leg)

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Ages Eligible for Study: | Child, Adult, Older Adult |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adults
- Acute hip fractures
- Severe pain
- Patients, or their legal representatives, provided written informed consent for procedure.
Exclusion Criteria:
- Women in pregnancy
- Trauma score greater than or equal to 16
- Incomplete data

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03885739
Colombia | |
hospital universitario San Vicente Fundacion | |
Medellin, Antioquia, Colombia |
Responsible Party: | Adriana Margarita Cadavid, Anesthesiologist. Specialist in Pain Medicine. Director and Clinical Professor of the Subspecialty in Pain Medicine, University of Antioquia, Universidad de Antioquia |
ClinicalTrials.gov Identifier: | NCT03885739 |
Other Study ID Numbers: |
UdeA1004 |
First Posted: | March 22, 2019 Key Record Dates |
Last Update Posted: | May 30, 2019 |
Last Verified: | May 2019 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Undecided |
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 |
Fractures, Bone Hip Fractures Wounds and Injuries |
Femoral Fractures Hip Injuries Leg Injuries |