Efficacy of Dexmedetomidine As an Adjuvant to Bupivacaine in Pericapsular Nerve Group Block in Hip Replacement Surgeries

Summary

Our aim will be to investigate the efficacy of dexmedetomidine as an adjuvant to bupivacaine in ultrasound guided pericapsular nerve group (PENG) block for postoperative analgesia in hip replacement surgeries.

* Our primary outcome of the study: total amount of postoperative morphine consumption in the first 24h postoperative.
* Our secondary outcome of the study: postoperative analgesia assessed by pain score (by Visual Analog Scale)

Conditions

• PENG Block

Interventions

PROCEDURE

Ultrasound guided Pericapsular Nerve Group Block

With the patient in the supine position and the leg slightly abducted, a curvilinear transducer (2.5-7.5 MHz) is prepared with sterile conduction gel and covered with a sterile probe cover. The transducer is placed transversely over the anterior superior iliac spine (ASIS), then aligned with the pubic ramus and rotated approximately 45° parallel to the inguinal crease. The probe is slid medially to identify key landmarks: the anterior inferior iliac spine (AIIS), iliopubic eminence (IPE), iliopsoas tendon, femoral artery, and femoral nerve. Sliding the probe distally or tilting caudally exposes the femoral head. A 20-22 gauge echogenic needle (100 mm) is inserted in-plane from lateral to medial, targeting the plane between the psoas tendon and the pubic ramus. the anesthetic agent is deposited to lift the psoas tendon while avoiding tendon puncture.

DRUG

Isobaric Bupivacaine 0. 25%

group c will receive PENG block with only 20ml isobaric bupivacaine 0.25%

DRUG

20 ml isobaric bupivacaine 0.25% and 1.5μg/kg dexmedetomidine

group D will receive PENG block with 20 ml isobaric bupivacaine 0.25% and 1.5μg/kg dexmedetomidine

DEVICE

the ultrasound machine with curvilinear transducer (high -frequency probe, 2.5Mhz to 7.5Mhz)

the two groups will receive the PENG block under ultrasound guidance

DEVICE

a standard echogenic 20-22 gauge 100mm needle

the two groups will receive the PENG block using a standard echogenic 20-22 gauge 100mm needle

Sponsors & Collaborators

• Assiut University

  lead OTHER

Principal Investigators

• Mohamed Mohamed Abd Ellatif · Anesthesia, Intensive Care and Pain management ,Faculty of medicine, Assiut University

• Shereen Mamdooh Mohamed · Anesthesia, Intensive Care and Pain management South Egypt Cancer Institute, Assiut University

• Moaaz Mohamed Tohamy · Anesthesia, Intensive Care and Pain management South Egypt Cancer Institute, Assiut University

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

90 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-03-01

Primary Completion

2026-08-31

Completion

2027-03-31

FDA Drug

Yes

FDA Device

Yes