PENG nerve block with different steroid and sedative combinations for hip surgery in adults 65 and older
Comparison of Three Variants of PENG Block Using 20 mL of 0.2% Ropivacaine With Different Combinations of Dexamethasone and Perineural Dexmedetomidine in Patients Aged 65 Years and Older Undergoing Hip Surgery: A Randomized Controlled Trial.
This trial will see if adding different combinations of dexamethasone and dexmedetomidine to a PENG nerve block gives adults 65 and older longer and better pain relief after hip surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 120 (estimated) |
| Ages | 65 Years to 100 Years |
| Sex | All |
| Sponsor | Poznan University of Medical Sciences Academic / other |
| Locations | 1 site (Poznan) |
| Trial ID | NCT07327931 on ClinicalTrials.gov |
What this trial studies
This randomized interventional study enrolls adults aged 65 and older undergoing elective or emergency hip surgery and compares three versions of the Pericapsular Nerve Group (PENG) block. All participants receive 20 mL of 0.2% ropivacaine, then are randomized to receive either intravenous dexamethasone, perineural dexmedetomidine plus intravenous dexamethasone, or both dexmedetomidine and dexamethasone given perineurally. Investigators will measure postoperative pain scores, opioid consumption, block duration, and functional recovery measures to determine which combination provides superior analgesia while preserving motor function. The trial excludes patients with coagulopathy, severe organ failure, pre-existing neuropathy, chronic opioid use, or contraindications to the study medications.
Who should consider this trial
Good fit: Adults aged 65 years or older scheduled for hip surgery who can give consent, are ASA I–III, and have no contraindication to regional anesthesia or the study medications.
Not a fit: Patients with active infection at the injection site, coagulopathy, severe hepatic or renal failure, pre-existing neuropathy, chronic daily opioid use, or allergy to ropivacaine, dexamethasone, or dexmedetomidine are unlikely to benefit or will be excluded.
Why it matters
Potential benefit: If successful, the best combination could prolong nerve-block pain relief, reduce opioid use, and help older hip surgery patients recover and mobilize sooner.
How similar studies have performed: Prior trials and meta-analyses of peripheral nerve blocks indicate that dexamethasone and dexmedetomidine can prolong block duration, but evidence is limited specifically for PENG blocks and for the optimal routes and combinations in older adults.
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, dexamethasone, 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.