PENG block plus local infiltration analgesia for anterior-approach hip replacement
PENG 360°: PENG Block + LIA Nella Endoprotesi di Anca Con Accesso Anteriore.
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.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | ASST Gaetano Pini-CTO Academic / other |
| Locations | 1 site (Milan) |
| Trial ID | NCT07239817 on ClinicalTrials.gov |
What this trial studies
This randomized comparison assigns adults having anterior‑approach hip endoprosthesis to either an ultrasound‑guided anterior/posterior PENG block combined with local infiltration analgesia (LIA) or to standard spinal anesthesia. The PENG+LIA arm uses targeted pericapsular sensory injections (A‑PENG and PONG) and a 360° LIA protocol intended to provide surgical anesthesia without major motor blockade. Primary outcomes include pain scores over the first 48 hours and time to first mobilization, with secondary outcomes capturing nausea and other side effects. The aim is to determine whether pain control is similar while allowing earlier leg movement and rehabilitation.
Who should consider this trial
Good fit: Adults (≥18) scheduled for hip endoprosthesis for a femoral fracture via the anterior surgical approach who can give informed consent and have no contraindications to local anesthetics.
Not a fit: Patients with prior major surgery or an existing prosthesis on the same hip, known allergy to local anesthetics, infection at the planned injection site, ASA class > IV, or those who require intraoperative opioids or conversion to general anesthesia are excluded and unlikely to benefit.
Why it matters
Potential benefit: If successful, this approach could provide comparable pain relief with less leg weakness, enabling earlier walking and potentially fewer anesthesia‑related side effects.
How similar studies have performed: Smaller studies and case series of PENG and other motor‑sparing regional techniques have reported promising analgesia and preserved motor function, but randomized comparisons of PENG+LIA versus spinal anesthesia are still limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Provision of signed and dated informed consent form. * Scheduled for hip endoprosthesis surgery for femoral fracture with an anterior approach. * Age 18 years or older. * Willing and able to comply with the study protocol. Exclusion Criteria: * Failure to provide informed consent. * Age less than 18 years. * Known allergy to local anesthetics or other medications used in the protocol. * Presence of infection at the planned injection site. * Pre-existing hip prosthesis or prior major surgery on the same hip (e.g., revision surgery). * ASA physical status class \> IV. * Administration of intraoperative opiates or conversion to general anesthesia.
Where this trial is running
Milan
- Gaetano Pini-CTO — Milan, Italy (Recruiting)
Study contacts
- Principal investigator: Romualdo Del Buono, MD — Unit of Anesthesia, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy;
- Study coordinator: Romualdo Del Buono, MD
- Email: romualdo.delbuono@asst-pini-cto.it
- Phone: +39 02 5829 6592
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.