PENG nerve block plus dexmedetomidine for hip surgery pain in older adults
Effect of Perineural Dexmedetomidine as an Adjuvant to Pericapsular Nerve Group Block in Older Adults: A Randomized Controlled Trial
This will test whether adding a small dose of dexmedetomidine to a PENG nerve block gives longer, better pain relief and reduces opioid need for people 65 and older having hip surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 30 (estimated) |
| Ages | 65 Years to 100 Years |
| Sex | All |
| Sponsor | Poznan University of Medical Sciences Academic / other |
| Locations | 1 site (Poznan) |
| Trial ID | NCT07327372 on ClinicalTrials.gov |
What this trial studies
This is a prospective, randomized, controlled trial in older adults undergoing hip surgery comparing a PENG block with ropivacaine alone versus ropivacaine plus low-dose dexmedetomidine. Participants 65 years and older who are eligible for a PENG block will be randomly assigned to one of the two regimens and followed for postoperative pain scores, opioid consumption, motor function, and complications. The trial is single-center at Poznan University of Medical Sciences and uses ultrasound-guided PENG block as part of multimodal perioperative analgesia. Safety monitoring will include assessment for hemodynamic effects, neurologic status, and adverse events related to regional anesthesia and study drugs.
Who should consider this trial
Good fit: Ideal candidates are adults aged 65 or older scheduled for elective or emergency hip surgery who can provide informed consent and have no contraindication to a PENG block or the study medications.
Not a fit: Patients with allergies to ropivacaine or dexmedetomidine, pre-existing neurologic deficits in the limb, significant coagulopathy, severe hepatic or renal failure, chronic daily opioid use, severe cognitive impairment, or BMI over 40 would not be eligible and are unlikely to receive benefit from this protocol.
Why it matters
Potential benefit: If successful, adding dexmedetomidine could prolong analgesia, lower opioid use, and help older patients mobilize sooner after hip surgery.
How similar studies have performed: Other regional hip-block techniques and small trials of dexmedetomidine as an adjuvant have shown prolonged analgesia and reduced opioid use, but data specifically on dexmedetomidine added to the PENG block in older adults are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age 65 years or older * Scheduled for elective or emergency hip surgery (e.g., hip fracture fixation or hip arthroplasty) * ASA physical status I-III * Ability to communicate pain intensity using the NRS scale * Written informed consent obtained from the patient or legal representative * Planned use of PENG block as part of multimodal perioperative analgesia Exclusion Criteria: * Patient refusal or inability to provide informed consent * Allergy, intolerance, or contraindication to any study medication: ropivacaine, dexmedetomidine * Pre-existing neurological deficit or neuropathy of the affected limb * Coagulopathy (INR \>1.5, platelets \<100,000/µL) or current therapeutic anticoagulation that contraindicates regional anesthesia * Infection at or near the injection site * Severe hepatic or renal impairment * History of chronic opioid use (daily opioids \>30 days before surgery) * Cognitive impairment or delirium precluding reliable pain assessment * BMI \> 40 kg/m² (if you want to exclude for technical difficulty) * Patients receiving another regional nerve block for hip surgery * Pregnancy or breastfeeding * Participation in another interventional clinical trial within 30 days
Where this trial is running
Poznan
- Poznan University of Medical Sciences — Poznan, Poland (Recruiting)
Study contacts
- Study coordinator: Malgorzata Reysner, MD PhD
- 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.