Low-Volume PENG Block With Dexamethasone 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 interventional phase 4 study compares two ultrasound-guided PENG block regimens in adults undergoing primary unilateral total hip arthroplasty under spinal anesthesia. The low-volume approach uses 10 mL of bupivacaine 0.25% with 4 mg dexamethasone, aiming to reduce spread to the femoral nerve and preserve quadriceps function, while potentially shortening analgesic duration. The standard-volume approach uses 20 mL of bupivacaine 0.25% without specified corticosteroid optimization beyond multimodal analgesia. Outcomes focus on time to first rescue analgesia and postoperative pain and mobility, with attention to opioid-sparing effects and motor preservation. Background context notes that PENG blocks target articular branches around the hip and have shown analgesic benefits, but motor-sparing claims with higher volumes may not always hold.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Physical status ASA I or II.
* Age 50-70 years.
* Patients scheduled for elective primary unilateral total hip arthroplasty under spinal anaesthesia.
* No sex predilection.

Exclusion Criteria:

* Patient refusal.
* Physical status ASA III or above.
* Contraindications to spinal anaesthesia (coagulopathy, local infection at injection site, raised intracranial pressure).
* Revision or bilateral total hip arthroplasty.
* Known allergy or hypersensitivity to study drugs (bupivacaine, dexamethasone) or to any component of the multimodal analgesic regimen (paracetamol, nalbuphine).
* Pre-existing neuromuscular disease, lower-limb motor deficit, or neuropathic pain syndrome.
* Uncontrolled diabetes mellitus (HbA1c \> 8% or fasting blood glucose \> 180 mg/dL) or any contraindication to corticosteroids.
* Cognitive impairment precluding pain and motor assessment, or chronic opioid use.
* Body mass index greater than 40 kg/m2 precluding adequate ultrasound visualization.

Where it's running

• Ain Shams University Hospitals (El Demerdash Hospital)
  Cairo, Cairo Governorate, Egypt Recruiting

Study contacts

• Principal investigator: Mohamed F Morsi, M.B., B.Ch., M.Sc. — Faculty of Medicine, Ain Shams University
• Study coordinator: Mohamed F Morsi, M.B., B.Ch., M.Sc.
• Email: MohamedMorsi@med.asu.edu.eg
• Phone: +201116618163

Similar studies

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

• PENG block plus local infiltration analgesia for anterior-approach hip replacement

  This test sees if a motor-sparing PENG block combined with local infiltration around the hip controls pain as well as spinal anesthesia for adults having anterior‑approach hip replacement.

  Recruiting ASST Gaetano Pini-CTO · Milan · NCT07239817

• Effects of Depo-Medrol on Psoas Muscle After Lumbar Spine Surgery

  This study tests if giving a corticosteroid called Depo-Medrol to the psoas muscle after lumbar spine surgery can help reduce thigh pain and improve hip strength compared to patients who don’t receive the injection.

  Recruiting Phase 4 UConn Health · Farmington, Connecticut · NCT05929755

• Targeted NMES to improve breathing and leg/extra muscle strength in COPD

  This study tests whether targeted neuromuscular electrical stimulation helps people with COPD see improvements in breathing muscle function and overall muscle strength.

  Recruiting Universitas Padjadjaran · Bandung, West Java · NCT07910006

• Tau changes after hip or knee replacement surgery

  Researchers will see if brain tau changes after hip or knee surgery and whether these changes relate to inflammation and thinking abilities.

  Recruiting Uppsala University Hospital · Uppsala · NCT07871487

• Analgesia after open inguinal hernia repair using intrathecal morphine or a transversalis fascia plane block

  This trial tests whether intrathecal morphine or a ultrasound-guided transversalis fascia plane block can provide better pain relief after open inguinal hernia repair in adults.

  Recruiting Atatürk Chest Diseases and Chest Surgery Training and Research Hospital · Yenimahalle, Ankara · NCT07826741

• Single-level vs two-level erector spinae plane block for breast surgery

  This study tests whether a single-level ESPB provides similar pain relief to a two-level ESPB for adults undergoing breast surgery.

  Recruiting Atatürk Chest Diseases and Chest Surgery Training and Research Hospital · Yenimahalle, Ankara · NCT07747623

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.