PENG vs FIC Nerve Blocks for Hip Fracture Pain
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests two methods to manage pain from hip fractures in the emergency department without heavily relying on opioids. It compares the PENG block, a newer technique targeting specific nerves around the hip, with the more established FIC block (Fascia Iliaca Compartment Block), both using the local anesthetic Bupivacaine. The goal is to determine if the PENG block is as effective as the FIC block in easing pain. Suitable participants have a hip fracture, experience significant pain (a pain score of 5 or higher), and can communicate their pain level. As an unphased trial, this study offers an opportunity to contribute to innovative pain management strategies without heavy opioid use.
Do I need to stop my current medications to join the trial?
The trial does not specify if you need to stop taking your current medications, but it does exclude patients who are on long-term systemic opioid analgesia.
What prior data suggests that these nerve block techniques are safe for treating hip fracture pain?
Previous studies have shown that the PENG block effectively relieves pain in patients with hip fractures and causes less thigh muscle weakness compared to other methods. One study found lower pain levels at 12, 24, and 48 hours after using the PENG block, indicating good pain control over time. This suggests that the PENG block is generally well-tolerated.
Research on the FIC block has shown it to be a safe and effective way to manage pain from hip fractures, providing consistent relief regardless of the doctor's experience. Another study confirmed its safety for emergency pain relief, especially in older patients.
Both the PENG and FIC blocks use bupivacaine, a common local anesthetic. While bupivacaine is widely used and generally safe, it can have side effects. However, studies have reported that both blocks provide effective pain relief with good safety profiles.12345Why are researchers excited about this trial?
Researchers are excited about comparing the PENG block and the FIC block for hip fracture pain because they offer different approaches to pain management. The PENG block targets the pericapsular nerve group, delivering Bupivacaine 0.50% directly to the hip area, potentially providing more localized and effective pain relief. On the other hand, the FIC block uses a larger volume of Bupivacaine 0.25% and targets the fascia iliaca compartment, which might offer broader pain coverage. Both methods are minimally invasive and could offer faster, more targeted pain relief compared to traditional systemic pain medications, reducing the need for opioids and their associated side effects.
What evidence suggests that this trial's treatments could be effective for hip fracture pain?
This trial will compare the PENG block and the FIC block for managing hip fracture pain. Research has shown that the PENG block provides significant pain relief and reduces the need for opioids, cutting morphine use by 50-70%. It minimally affects muscle movement, helping to maintain mobility. Studies have found that the PENG block effectively reduces pain and aids recovery after a hip fracture. In contrast, the FIC block is a well-established method for managing hip fracture pain, reliably reducing pain in the first few hours after use. Both methods are considered safe and effective, but no direct comparison has determined which one is superior. Participants in this trial will receive either the PENG block or the FIC block to evaluate their effectiveness.24678
Who Is on the Research Team?
Lawrence Haines, MD
Principal Investigator
Maimonides Medical Center
Are You a Good Fit for This Trial?
This trial is for adults over 18 with an isolated hip fracture and a pain score of 5 or more. It's not for those with multiple injuries, communication issues about pain, pregnancy, under 18 years old, intoxication, abnormal vital signs, long-term opioid use or allergy to certain local anesthetics.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive either a PENG block or a FIC block for pain management in the ED
Immediate Follow-up
Participants' pain scores and motor function are assessed at 30 and 60 minutes post nerve block
Follow-up
Participants are monitored for any adverse events and rescue medication usage after the nerve block
What Are the Treatments Tested in This Trial?
Interventions
- FIC Proceedure
- PENG Proceedure
FIC Proceedure is already approved in United States, European Union, Canada for the following indications:
- Pain management for hip fractures
- Pain management for orthopedic injuries
- Pain management for hip fractures
- Pain management for orthopedic injuries
- Pain management for hip fractures
- Pain management for orthopedic injuries
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Who Is Running the Clinical Trial?
Antonios Likourezos
Lead Sponsor