PENG block versus combined lumbar and sacral erector spinae plane (ESP) blocks for pain after total hip replacement
Official title: 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
Run by Poznan University of Medical Sciences · NCT07180979 · Data updated 2026-11-12
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 |
| Ages | 65 Years to 100 Years |
| Sex | All |
| Enrollment | 90 (estimated) |
| Sponsor | Poznan University of Medical Sciences Academic / other |
| Locations | 1 site (Poznan) |
| Status | Recruiting |
| Started | September 15, 2025 |
| Main results expected | September 30, 2027 |
| Study ends | November 30, 2027 |
| Registry record updated | November 5, 2026 |
| Trial ID | NCT07180979 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a 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.
✕Probably 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.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
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.
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 gone: 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.
Who can join: the full rules
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 it's running
-
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
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.