PENG Block: Continuous Infusion vs. Programmed Intermittent Bolus in Neck of Femur Fracture
A Double Blind Randomised Controlled Trial Comparing Continuous Infusion vs. Programmed Intermittent Bolus Via a Pericapsular Nerve Group (PENG) Catheter for Post Operative Fractured Neck of Femur Analgesia
University College Cork
150 participants
Mar 28, 2024
INTERVENTIONAL
Conditions
Summary
Pericapsular Nerve Group Block (PENG) is an effective regional anaesthesia modality in providing analgesia following neck of femur fracture. Continuous PENG techniques, using indwelling catheters and infusions of local anaesthetic, facilitate the continuation of analgesia for a number of days following hip fracture surgery. It is unclear from the published literature whether an optimal strategy of local anaesthetic delivery has been characterized. Similar doses of local anaesthetic agents can be administered by either continuous infusion or timed intermittent bolus. It is unclear whether one dosing strategy is superior to the other in the context of hip fracture analgesia. The study aims to evaluate the clinical efficacy of both dosing strategies in patients undergoing hip fracture surgery.
Eligibility
Inclusion Criteria4
- English-speaking
- over the age of 18 years
- hemiarthroplasty for fractured neck of femur
- able to provide written consent.
Exclusion Criteria6
- under 50kg body weight.
- unable to provide consent due to incapacity
- pregnant women
- vulnerable adults under state guardianship
- Patients with pre-existing chronic pain disorders or with a history of long-term opioid use
- those with contraindications to a peripheral nerve block such as local site infection, allergy to local anaesthetic or those who are coagulopathic
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Interventions
Participants in this arm will receive a continuous infusion of levobupivacaine via a regional anaesthesia catheter placed in the PENG fascial space. The total dose over 24 hours will be equivalent in both arms of the study.
Participants in this arm will receive a timed pre-set bolus dose of levobupivacaine via a regional anaesthesia catheter placed in the PENG fascial space. The total dose over 24 hours will be equivalent in both groups.
Locations(1)
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NCT07046052