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PENG vs Femoral Block for Hip Fracture Analgesia

ConditionHip Fractures
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorWeill Medical College of Cornell University

About this trial

This study aims to compare the Pericapsular Nerve Group (PENG) block with femoral block for hip fracture pain. Participants presenting to the hospital with a diagnosis of hip fracture and consenting to analgesic block will receive either a PENG or femoral block. The choice of block will be dictated by a randomized monthly schedule, and all participants presenting during each four-week period will receive the designated block. A sub-group analysis will be performed to determine any difference in efficacy in participants with intracapsular versus extracapsular fractures.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Male or female ≥ 18 years of age.

ASA Classification 1-4

Documentation of a hip fracture diagnosis along with radiologic read indicating fracture location

Written, informed consent for analgesic peripheral block placement

Disqualifiers

Altered mental status to the extent that it limits ability to report pain score

Patient or health care proxy refusal of analgesic nerve block

Allergy to study medications or contraindication to peripheral nerve block

Peri-prosthetic fracture

Trial design

Design model

Crossover

Treatments tested in this trial

  • PENG Block Administration

    Procedure/Surgery

    Policy for the PENG block administration: 30 mL of Bupivacaine 0.25% 1:200,000 epinephrine Dexamethasone 4 mg% While these drugs are administered to participants, the intervention under evaluation is the PENG Block anesthesia technique.

  • Femoral Block Administration

    Procedure/Surgery

    Policy for the Femoral block administration: 30 mL of Bupivacaine 0.25% 1:200,000 epinephrine Dexamethasone 4 mg While these drugs are administered to participants, the intervention under evaluation is the Femoral Block anesthesia technique.

  • Bupivacaine , epinephrine Dexamethasone

    Drug

    30 mL of Bupivacaine 0.25% 1:200,000 epinephrine Dexamethasone 4 mg%

Treatment groups

352 Participants
are divided into 2 treatment groups
Group A: PENG Block AdministrationExperimental treatment 2 interventions
Group B: Femoral Block AdministrationExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Mean Change in Numerical Rating Scale (NRS) Pain Score One Hour Post Block for all Subjects

The Numerical Rating Scale (NRS) measures the intensity of pain a subject experiences. where subjects rate their pain on a scale from zero to ten and each number corresponds to a different level of intensity. The lowest score 0 represents no pain and the highest score 10 represents the most intense feeling of pain.

Time frame
Baseline, 1-hour post block
2

Mean Change in Numerical Rating Scale (NRS) Pain Score One-Hour Post Block in Intracapsular Hip Fractures

The Numerical Rating Scale (NRS) measures the intensity of pain a subject experiences. where subjects rate their pain on a scale from zero to ten and each number corresponds to a different level of intensity. The lowest score 0 represents no pain and the highest score 10 represents the most intense feeling of pain.

Time frame
Baseline, 1-hour post block
3

Mean Change in Numerical Rating Scale (NRS) Pain Score One-Hour Post Block in Extracapsular Hip Fractures

The Numerical Rating Scale (NRS) measures the intensity of pain a subject experiences. where subjects rate their pain on a scale from zero to ten and each number corresponds to a different level of intensity. The lowest score 0 represents no pain and the highest score 10 represents the most intense feeling of pain.

Time frame
Baseline, 1-hour post block

Secondary outcomes

1

Mean NRS Pain Scores up to 24 Hours Post-block for all Subjects

The Numerical Rating Scale (NRS) measures the intensity of pain a subject experiences. where subjects rate their pain on a scale from zero to ten and each number corresponds to a different level of intensity. The lowest score 0 represents no pain and the highest score 10 represents the most intense feeling of pain.

Time frame
0-24 hours post block
2

Mean NRS Pain Scores up to 24 Hours Post-block in Intracapsular Hip Fractures

The Numerical Rating Scale (NRS) measures the intensity of pain a subject experiences. where subjects rate their pain on a scale from zero to ten and each number corresponds to a different level of intensity. The lowest score 0 represents no pain and the highest score 10 represents the most intense feeling of pain.

Time frame
0-24 hours post block
3

Mean NRS Pain Scores up to 24 Hours Post-block in Extracapsular Hip Fractures

The Numerical Rating Scale (NRS) measures the intensity of pain a subject experiences. where subjects rate their pain on a scale from zero to ten and each number corresponds to a different level of intensity. The lowest score 0 represents no pain and the highest score 10 represents the most intense feeling of pain.

Time frame
0-24 hours post block
4

Number of Oral Morphine Equivalents Administered for all Subjects

Milligrams of oral morphine equivalent opioid consumption up to 24 hours post-block. Non-morphine opioids will be converted to an equivalent morphine dosage in milligrams for comparison across both block types. Oral morphine equivalent dosages are calculated using: Wen RY et al. A Comparison of Institutional Opioid Equianalgesia Tools: A National Study. J Palliat Med. 2022;25:1686

Time frame
0-24 hours post block

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Weill Medical College of Cornell University

Lead sponsor

New York Presbyterian Hospital

Collaborator

Source ClinicalTrials.gov
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