PENG Block added to spinal anesthesia for hip replacement in older adults

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, parallel-group trial compares ultrasound-guided Pericapsular Nerve Group (PENG) block plus spinal anesthesia versus a sham block with local anesthetic to see if delirium within 72 hours after primary total hip arthroplasty is reduced in adults aged 75 and older. Participants are adults with ASA II-III undergoing elective surgery and will be assigned 1:1 to receive the PENG block or sham block. The study focuses on opioid-sparing analgesia and improved mobilization as potential mechanisms to decrease delirium risk. Outcomes include incidence of postoperative delirium and related recovery measures in the early postoperative period.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age ≥ 75 years
* Scheduled for elective primary total hip arthroplasty
* Planned spinal anesthesia
* ASA physical status II-III
* Ability to provide written informed consent
* Ability to communicate and reliably assess pain using the Numeric Rating Scale (NRS)
* Expected postoperative hospitalization ≥ 72 hours

Exclusion Criteria:

* Pre-existing delirium, acute psychosis, or active major psychiatric disorder
* Documented severe dementia or inability to provide informed consent
* Severe hearing or visual impairment preventing reliable CAM assessment
* Contraindications to regional anesthesia (e.g., coagulopathy according to institutional standards, infection at the injection site, allergy to local anesthetics)
* Pre-existing neurological deficits of the operative lower limb are interfering with assessment
* Chronic opioid use (\>30 mg morphine milligram equivalents per day for \>2 weeks prior to surgery)
* Severe renal impairment (eGFR \<30 mL/min/1.73 m²)
* Severe hepatic insufficiency
* Participation in another interventional clinical trial within 30 days
* Any other condition that, in the investigator's judgment, may interfere with study participation or protocol adherence

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 8320122

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.