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PENG vs L-ESPB With S-ESPB for Analgesia in Total Hip Arthroplasty

ConditionsHip OsteoarthritisHip ArthropathyHip Pain Chronic
Trial statusRecruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age65-100
SponsorPoznan University of Medical Sciences

About this trial

The goal of this clinical trial is to evaluate whether different types of regional anesthesia can improve pain control and functional recovery after total hip arthroplasty in adult patients undergoing elective hip replacement surgery.

The main questions it aims to answer are:

Does the PENG block reduce opioid use in the first 48 hours after surgery more effectively than the combined L-ESPB + S-ESPB technique? Which method provides better pain relief, preserves muscle strength, and supports earlier mobilization? Researchers will compare the Pericapsular Nerve Group (PENG) block with the combination of Lumbar and Sacral Erector Spinae Plane Blocks (L-ESPB + S-ESPB) to see which provides better pain control, fewer side effects, and faster recovery.

Participants will:

Be randomly assigned to receive one of the two types of ultrasound-guided regional anesthesia Undergo standard hip replacement surgery under spinal anesthesia Be monitored for pain scores, opioid use, time to first walking, muscle strength, satisfaction, and side effects over the first 48 hours after surgery.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age ≥ 65 years

ASA physical status I-III

Elective unilateral THA via posterior or lateral approach

Informed consent provided

Disqualifiers

Allergy to study drugs (ropivacaine, dexamethasone)

Chronic opioid use (>30 MME/day)

Coagulopathy or infection at the injection site

BMI > 40 kg/m²

Trial design

Design model

Parallel

Treatments tested in this trial

  • Ropivacaine 0.5% Injectable Solution

    Drug

    All patients will receive standard spinal anesthesia with 0.5% ropivacaine, 10-15 mg intrathecally for total hip arthroplasty.

  • Ropivacaine 0.2% Injectable Solution

    Drug

    Ultrasound-guided pericapsular nerve group (PENG) block and lateral femoral cutaneous nerve (LFCN) block, with sham lumbar and sacral ESPBs. PENG block: 20 mL of 0.2% ropivacaine. LFCN block: 5 mL of 0.2% ropivacaine. Sham lumbar ESPB: 1-2 mL preservative-free normal saline at lumbar ESPB site. Sham sacral ESPB: 1-2 mL preservative-free normal saline at sacral ESPB site. All patients will receive standard spinal anesthesia with 0.5% ropivacaine, 10-15 mg intrathecally for total hip arthroplasty.

  • Ropivacaine 0.2% Injectable Solution

    Drug

    Ultrasound-guided lumbar erector spinae plane block (L-ESPB) and sacral erector spinae plane block (S-ESPB), with sham PENG and LFCN blocks. Lumbar ESPB: 20 mL of 0.2% ropivacaine at L3 transverse process level. Sacral ESPB: 20 mL of 0.2% ropivacaine at sacral intermediate crest. Sham PENG block: 1-2 mL preservative-free normal saline at PENG site. Sham LFCN block: 1-2 mL preservative-free normal saline at LFCN site. All patients will receive standard spinal anesthesia with 0.5% ropivacaine, 10-15 mg intrathecally for total hip arthroplasty.

Treatment groups

90 Participants
are divided into 3 treatment groups
Group A: Control groupPlacebo comparator 1 intervention
Group B: PENG + LFCNActive comparator 1 intervention
Group C: L-ESPB + S-ESPBActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Total opioid consumption

morphine milligram equivalents (MME)

Time frame
first 48 hours postoperatively

Secondary outcomes

1

Pain scores

Numeric Rating Scale (NRS), ranging from 0 ("no pain") to 10 ("the worst pain imaginable")- at rest and during mobilization

Time frame
4 hours after surgery
2

Pain scores

Numeric Rating Scale (NRS), ranging from 0 ("no pain") to 10 ("the worst pain imaginable")- at rest and during mobilization

Time frame
8 hours after surgery
3

Pain scores

Numeric Rating Scale (NRS), ranging from 0 ("no pain") to 10 ("the worst pain imaginable")- at rest and during mobilization

Time frame
12 hours after surgery
4

Pain scores

Numeric Rating Scale (NRS), ranging from 0 ("no pain") to 10 ("the worst pain imaginable")- at rest and during mobilization

Time frame
24 hours after surgery

Other outcomes

Sponsors and contacts

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

Poznan University of Medical Sciences

Lead sponsor

Source ClinicalTrials.gov
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