Comparing two nerve-block approaches for pain after anterior-approach hip replacement
Lateral Femoral Cutaneous Nerve (LFCN) Block or Wound Infiltration (WI) Combined With Pericapsular Nerve Group (PENG) Block for Analgesia in Elective Anterior Approach Total Hip Arthroplasty: A Randomized Controlled Trial
This trial tests whether adding a lateral femoral cutaneous nerve block or using surgical wound infiltration together with a PENG block gives better pain relief after anterior-approach total hip replacement.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 102 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Ospedale Edoardo Bassini Academic / other |
| Locations | 1 site (Cinisello Balsamo, Milano) |
| Trial ID | NCT07284615 on ClinicalTrials.gov |
What this trial studies
This randomized controlled trial enrolls adults undergoing elective anterior-approach total hip arthroplasty and randomizes them to receive either a PENG block plus a lateral femoral cutaneous nerve (LFCN) block or a PENG block plus wound infiltration. All patients receive spinal anesthesia and the regional techniques are performed as part of routine perioperative care. The primary outcome is pain at rest on a numerical rating scale six hours after surgery, and secondary outcomes include dynamic pain at multiple time points, total opioid consumption, time to first rescue analgesia, quadriceps strength, hip flexion angle, length of stay, and adverse events. Safety will be continuously monitored by the principal investigator and study team according to an internal safety plan.
Who should consider this trial
Good fit: Adults (over 18) scheduled for elective anterior-approach total hip replacement under spinal anesthesia who can give informed consent and do not have major clotting problems or allergies to local anesthetics.
Not a fit: Patients with significant coagulopathy, active infection at the puncture site, documented allergy to local anesthetics, those receiving general anesthesia, or those undergoing non-anterior surgical approaches are unlikely to qualify or benefit.
Why it matters
Potential benefit: If successful, the better technique could provide stronger pain relief, reduce opioid needs, and help preserve leg strength after anterior hip replacement.
How similar studies have performed: Prior studies of PENG and other regional blocks for hip surgery have shown improved postoperative analgesia and reduced opioid use, but direct comparisons of PENG plus LFCN versus PENG with wound infiltration are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age \> 18 years * Elective total hip arthroplasty * Spinal (subarachnoid) anesthesia * Written informed consent provided by the patient or by the legal guardian, if appointed Exclusion Criteria: * INR \> 1.5 * aPTT \> 1.5 * Platelet count \< 75,000/mm³ * Signs suggestive of infection at the puncture site * Absence of informed consent to the procedure * Documented or suspected allergy to local anesthetics
Where this trial is running
Cinisello Balsamo, Milano
- Ospedale Edoardo Bassini — Cinisello Balsamo, Milano, Italy (Recruiting)
Study contacts
- Study coordinator: Matteo Coccolo, MD
- Email: matteo.coccolo@asst-nordmilano.it
- Phone: 0039025799
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.