Comparison of direct injection of Ropivacaine around the hip joint with pericapsular nerve group block (PENG) on opium consumption around the operation in patients undergoing Total hip Arthroplasty

Measuring the postoperative pain and opioid use in periarticular injection (PENG and direct) after total hip arthroplasty.

A clinical trial with 2 groups, with parallel groups, double-blind, randomized, phase 3 on 128 patients. For randomization, a simple randomization method is used

After the approval of the ethics committee and obtaining the consent of the patients, 128 candidates for hip arthroplasty surgery at Imam Hossein Hospital who meet the entry criteria will be included in the study. Patients are assigned to one of the two groups by simple randomization. Individuals responsible for randomization from the research team will not be responsible for examining the dependent variable. The data analyst will not know about the coding of the groups.

Candidate for total hip arthroplasty No history of pelvic surgery No history of drug abuse and other psychoactive substances No history of psychiatric disease No allergy to local anesthetics Unwillingness to participate in the study

Ultrasound group: The method of inducing analgesia will be the PENG method, in which 20 ml of 0.25% ropivacaine will be injected laterally to medially with a standard 100 mm, 22-gauge needle at the level between the tendon of the psoas muscle and the ramus pubis. Intervention group: 20 cc of 0.25% ropivacaine will be used and injected as a 5 ml injection into the ligamentum teres before stem placement, a five ml injection into the labrum after stem placement, and the remaining ten ml injection after capsular repair (5 ml into the capsule, 5 ml into the muscle).

Visual analog score

Creating a random sequence using a simple randomization method using 120 cards (60 cards for each group) that are placed inside opaque sealed envelopes and will be shuffled by the patients before choosing.

The patients and the person responsible for data collection and the person analyzing will be unaware of the coding. Only the anesthesiologist and orthopedic surgeon will be aware of the patient's group during surgery and will perform coding for each group.