PENG plus lateral femoral cutaneous nerve block versus lumbar and sacral erector spinae plane blocks for pediatric hip surgery

Comparison of Analgesic Efficacy of Pericapsular Nerve Group (PENG) Block With Lateral Femoral Cutaneous Nerve Block (LFCB) Versus Lumbar and Sacral Erector Spinae Plane Blocks (L-ESPB and S-ESPB) in Pediatric Hip Surgery: A Randomized Controlled Trial

This trial will test whether combining a PENG block with a lateral femoral cutaneous nerve block gives better pain relief and lowers opioid use than lumbar and sacral erector spinae plane blocks in children aged 2–16 having elective hip surgery.

Quick facts

• Phase: Phase 4
• Study type: Interventional
• Enrollment: 60 (estimated)
• Ages: 2 Years to 16 Years
• Sex: All
• Sponsor: Poznan University of Medical Sciences (Academic / other)
• Locations: 1 site (Poznan)
• Trial ID: NCT07023094 on ClinicalTrials.gov

What this trial studies

This randomized controlled trial enrolls children aged 2–16 undergoing elective orthopedic hip procedures to compare two regional anesthesia strategies: a pericapsular nerve group (PENG) block combined with a lateral femoral cutaneous nerve block versus lumbar and sacral erector spinae plane blocks. All blocks use 0.2% ropivacaine, and the protocol will examine whether adding dexamethasone or dexmedetomidine as adjuvants prolongs analgesia. Primary outcomes include postoperative pain scores and opioid consumption, with secondary measures of block-related complications and recovery milestones. The trial seeks to identify which technique provides superior analgesia and fewer opioid-related side effects in the pediatric hip surgery population.

Who should consider this trial

Good fit: Children aged 2–16 scheduled for elective orthopedic hip surgery (such as osteotomies, reconstructions, or arthroscopy) with ASA physical status I–III and written guardian consent are the intended participants.

Not a fit: Patients with infection at intended injection sites, coagulopathy or anticoagulant use, known allergy to study drugs, significant neurological or cognitive impairment, chronic opioid use, or other severe systemic disease are unlikely to benefit or may be ineligible.

Why it matters

Potential benefit: If successful, the preferred block technique could reduce postoperative pain and opioid requirements and speed recovery after pediatric hip surgery.

How similar studies have performed: Early adult studies and limited pediatric reports suggest PENG and erector spinae plane blocks can provide effective hip analgesia, but direct randomized comparisons in children are limited.

Eligibility criteria

Inclusion Criteria:

* Pediatric patients aged between 2 and 16 years.
* Scheduled for elective orthopedic hip surgery, including: Osteotomies and Hip reconstruction surgeries
* ASA (American Society of Anesthesiologists) physical status classification: I-III.
* Written informed consent obtained from the patient's legal guardian(s).

Exclusion Criteria:

* Known allergy or hypersensitivity to any of the study medications
* Presence of infection or inflammation at the intended injection site(s) of regional anesthesia.
* Coagulopathy or bleeding disorders (including patients on anticoagulant therapy) that contraindicate nerve blocks.
* Neurological disorders or peripheral neuropathies that could influence sensory or motor assessment of the lower limbs.
* Cognitive impairment or behavioral disorders significantly affecting pain assessment accuracy or cooperation.
* History of chronic opioid use or known substance abuse.
* Severe systemic disease or condition compromising patient safety or interfering with study protocol adherence.

Where this trial is running

Poznan

• Poznan University of Medical Sciences — Poznan, Poland (Recruiting)

Study contacts

• Principal investigator: Malgorzata Reysner, M.D. Ph.D. — Poznan University of Medical Sciences
• Study coordinator: Malgorzata Reysner

Conditions Hip Disease; Hip Dysplasia; Hip Arthropathy