Comparing three motor-sparing nerve blocks for pain after hip replacement

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized, double-blinded, three-arm controlled study enrolls adults aged 65 and older undergoing elective hip arthroplasty under spinal anesthesia and randomizes them to receive a PENG block, suprainguinal FICB, or lumbar ESPB for postoperative analgesia. Investigators will compare postoperative pain scores at rest and during movement, opioid consumption, time to first rescue analgesia, quadriceps strength, incidence of nausea and vomiting, block-related adverse events, and early mobilization. Blocks are selected for their motor-sparing potential to facilitate early mobilization, and outcome data will be collected during at least 48 hours of postoperative hospitalization. The trial aims to determine which technique best balances effective analgesia with preserved motor function to improve early functional recovery after hip surgery.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Adults aged 65 years or older scheduled to undergo elective hip arthroplasty under spinal anesthesia.
* Ability to provide written informed consent.
* Ability to understand and reliably use numerical pain assessment tools (NRS 0-10).
* ASA physical status II-III.
* Expected postoperative hospitalization of at least 48 hours to ensure complete data collection.

Exclusion Criteria:

* Inability to provide informed consent due to cognitive impairment, language barrier, or severe hearing/speech limitations.
* Coagulopathy or therapeutic anticoagulation not meeting safety criteria for regional anesthesia.
* Local infection at the planned block site.
* Allergy, hypersensitivity, or contraindication to ropivacaine, local anesthetics, or study medications.
* Pre-existing lower-limb neurological deficits (motor or sensory) affecting outcome assessments.
* Severe spinal deformity or anatomical limitations preventing safe performance of regional blocks.
* Chronic opioid use (defined as \>30 mg oral morphine equivalents daily for more than 2 weeks).
* Severe renal failure (eGFR \<30 mL/min/1.73m²) or severe hepatic impairment.
* Uncontrolled diabetes mellitus (fasting glucose \>300 mg/dL or HbA1c \>10%).
* History of local anesthetic systemic toxicity (LAST).
* Participation in another interventional clinical trial within the past 30 days.
* Any condition deemed by investigators to interfere with protocol adherence, safety monitoring, or outcome reliability.

Where it's running

• Poznan University of Medical Sciences
  Poznan, Poland Recruiting

Study contacts

• Study coordinator: Malgorzata Reysner, MD PhD
• Email: mreysner@ump.edu.pl
• Phone: +48 61 873 83 03

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Ceramic hip resurfacing vs total hip arthroplasty for hip OA

  This trial tests whether ceramic hip resurfacing helps people with hip OA walk farther each day than a modern total hip replacement.

  Recruiting Danderyd Hospital · Danderyd · NCT07839403

• Dexmedetomidine during hip replacement to modulate nerves and inflammation

  A randomized, placebo-controlled study tests whether intravenous dexmedetomidine given during spinal anesthesia with a PENG nerve block can help regulate the body's stress and inflammatory response and improve recovery after hip replacement.

  Recruiting Poznan University of Medical Sciences · Poznan · NCT07743853

• Preoperative Fasting to Shape the Gut with Hip Replacement

  This trial tests whether a 20-day preoperative fasting plan can lower inflammatory signals and broaden gut microbes in adults undergoing total hip arthroplasty.

  Recruiting Charite University, Berlin, Germany · Berlin, State of Berlin · NCT07651462

• Cryoneurolysis for Chronic Pain: 6- and 12-Month Outcomes in Routine Care

  This study tests whether cryoneurolysis, done as part of standard care for people with chronic pain, leads to meaningful improvements over 6 to 12 months.

  Recruiting Yale University · Old Saybrook, Connecticut · NCT07639060

• Spinal anesthesia with intrathecal morphine vs PENG block (with or without dexamethasone) for hip replacement

  In people aged 60 and older undergoing total hip arthroplasty, this study tests whether three anesthesia approaches provide better pain control and fewer side effects: spinal with intrathecal morphine, spinal with a PENG block, or spinal with a PENG block plus dexamethasone.

  Recruiting Poznan University of Medical Sciences · Poznan · NCT07584200

• Intravenous dexamethasone for better pain control after hip replacement with a PENG block

  This study tests whether giving dexamethasone through a vein, in 0, 4, or 8 mg doses, helps control pain after total hip arthroplasty when used with a PENG block.

  Recruiting Poznan University of Medical Sciences · Poznan · NCT07581470

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.