PENG block versus combined lumbar and sacral erector spinae plane (ESP) blocks for pain after total hip replacement
Comparison of Pericapsular Nerve Group (PENG) Block Versus Lumbar Erector Spinae Plane Block (L-ESPB) Combined With Sacral ESPB (S-ESPB) for Analgesia in Total Hip Arthroplasty (THA): A Randomized Clinical Trial
This trial will test whether the PENG nerve block or a combined lumbar-plus-sacral ESP block gives better pain relief and reduces opioid use in adults aged 65 and older having elective total hip replacement.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Enrollment | 90 (estimated) |
| Ages | 65 Years to 100 Years |
| Sex | All |
| Sponsor | Poznan University of Medical Sciences Academic / other |
| Locations | 1 site (Poznan) |
| Trial ID | NCT07180979 on ClinicalTrials.gov |
What this trial studies
In this randomized, single-center trial adult patients undergoing elective unilateral total hip arthroplasty under spinal anesthesia will be assigned to receive either a PENG block or combined lumbar and sacral ESP blocks delivered with ultrasound guidance. Both groups receive standardized intraoperative care and postoperative monitoring for pain scores, opioid consumption in the first 48 hours, muscle strength, and time to first ambulation. The study uses ropivacaine at defined concentrations for the regional blocks and collects functional recovery and side-effect data during the early postoperative period. The trial is conducted at Poznan University of Medical Sciences and targets older adults (age ≥65) without major contraindications to regional anesthesia.
Who should consider this trial
Good fit: Ideal candidates are adults aged 65 or older with ASA physical status I–III scheduled for elective unilateral total hip arthroplasty via a posterior or lateral approach who can give informed consent.
Not a fit: Patients unlikely to benefit include those with BMI over 40, chronic high-dose opioid use (>30 MME/day), coagulopathy or infection at the injection site, pre-existing motor weakness or neuropathy, relevant drug allergies, or inability to consent.
Why it matters
Potential benefit: If successful, the preferred block could reduce opioid use, improve pain control, preserve motor strength, and help patients mobilize sooner after hip replacement.
How similar studies have performed: Prior observational studies and small trials suggest PENG and ESP blocks can provide motor-sparing hip analgesia, but no randomized trial has directly compared PENG with a dual-level (lumbar + sacral) ESP block in hip arthroplasty patients.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥ 65 years * ASA physical status I-III * Elective unilateral THA via posterior or lateral approach * Informed consent provided Exclusion Criteria: * Allergy to study drugs (ropivacaine, dexamethasone) * Chronic opioid use (\>30 MME/day) * Coagulopathy or infection at the injection site * BMI \> 40 kg/m² * Pre-existing motor weakness or neuropathy in the affected limb * Cognitive impairment precluding informed consent
Where this trial is running
Poznan
- Poznan University of Medical Sciences — Poznan, Poland (Recruiting)
Study contacts
- Principal investigator: Tomasz Reysenr, M.D. — Poznan Univesity of Medical Sciences
- Study coordinator: Malgorzata Reysner, M.D. Ph.D.
- Email: mreysner@ump.edu.pl
- Phone: +48 61 873 83 03
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.