Femoral nerve block versus combined PENG plus femoral nerve block for hip fracture surgery in older adults
A Prospective Randomized Controlled Trial Comparing Femoral Nerve Block and Combined Pericapsular Nerve Group (PENG) Plus Femoral Nerve Block for Perioperative Analgesia in Geriatric Hip Fracture Surgery
This trial tests whether adding a PENG block to a femoral nerve block reduces pain and opioid use after hip fracture surgery in people aged 65 and older.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 68 (estimated) |
| Ages | 65 Years and up |
| Sex | All |
| Sponsor | Ankara City Hospital Bilkent Academic / other |
| Drugs / interventions | chemotherapy |
| Locations | 1 site (Ankara) |
| Trial ID | NCT07350044 on ClinicalTrials.gov |
What this trial studies
This is a prospective, randomized controlled trial enrolling geriatric patients undergoing hip fracture surgery under spinal anesthesia to compare femoral nerve block alone versus a combined pericapsular nerve group (PENG) plus femoral nerve block. Participants are randomized to receive one of the two regional anesthesia approaches before surgery, with standardized perioperative analgesic protocols and monitoring. Primary outcomes include perioperative pain intensity and opioid consumption within the first 24 hours postoperatively, along with need for rescue analgesia and immediate motor function. The trial is conducted at Ankara Bilkent City Hospital with predefined inclusion and exclusion criteria to focus on medically appropriate older adults.
Who should consider this trial
Good fit: Ideal candidates are people aged 65 or older with a hip fracture scheduled for surgery under spinal anesthesia who are ASA physical status I–III, have a BMI of 18–40 kg/m², and can give informed consent.
Not a fit: Patients unlikely to benefit include those under 65, with severe cognitive impairment or ASA IV or higher, BMI over 40, those needing general anesthesia or revision/multiple-trauma cases, and those with contraindications to regional anesthesia or active systemic infection.
Why it matters
Potential benefit: If successful, the combined block could provide better pain control with lower opioid requirements and preserve motor function to help earlier mobilization.
How similar studies have performed: Small trials and case series suggest the PENG block can provide effective, motor-sparing hip analgesia, but randomized comparisons of combined PENG plus femoral block versus femoral block alone remain limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age 65 years and older, * Patients scheduled for surgery due to hip fracture, * American Society of Anesthesiologists (ASA) physical status I-III, * Body mass index between 18 and 40 kg/m², * Preoperative fasting duration of approximately 8 hours, * Planned spinal anesthesia, * Ability to provide written informed consent. Exclusion Criteria: * Age below 65 years, * Refusal to participate in the study, * Severe cognitive impairment, dementia, or Alzheimer's disease, * ASA physical status IV or higher, * Body mass index \> 40 kg/m², * Failed spinal anesthesia or conversion to general anesthesia, * Revision hip surgery, * Multiple trauma patients, * Old hip fractures (\>3 weeks), * Active malignancy receiving chemotherapy or radiotherapy, * Active infection requiring antibiotic treatment (except prophylaxis), * Contraindications to regional anesthesia techniques, * Chronic steroid or immunosuppressive therapy, * Use of anti-inflammatory drugs, * Non-fasted patients, * Allergy or intolerance to local anesthetics, paracetamol, tramadol, or other opioids.
Where this trial is running
Ankara
- Ankara Bilkent City Hospital — Ankara, Turkey (Türkiye) (Recruiting)
Study contacts
- Study coordinator: Sündüz İlayda Yıldız Akça
- Email: sunduzilayda@hotmail.com
- Phone: +905076111649
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.