PENG versus femoral nerve block for hip fracture pain
PENG vs Femoral Block for Hip Fracture, A Pragmatic Cluster-Randomized Study
This will test whether a PENG nerve block or a femoral nerve block gives better pain relief and reduces opioid use for adults with confirmed hip fractures who agree to a nerve block.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 352 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Weill Medical College of Cornell University Academic / other |
| Locations | 1 site (Manhattan, New York) |
| Trial ID | NCT07073209 on ClinicalTrials.gov |
What this trial studies
This randomized, alternating-month design compares ultrasound-guided Pericapsular Nerve Group (PENG) blocks to traditional femoral nerve blocks in adults presenting with radiologically confirmed hip fractures. Participants presenting during each four-week period receive the designated block, with standard local anesthetic (bupivacaine with epinephrine) and optional dexamethasone per protocol. Outcomes include pain scores, opioid consumption, incidence of confusional state/delirium, and time to mobilization, and a prespecified subgroup analysis will compare intracapsular versus extracapsular fractures. Eligible patients are adults (≥18 years) with ASA 1–4 who can consent and report pain and have no chronic preoperative opioid use or contraindications to peripheral nerve blocks.
Who should consider this trial
Good fit: Ideal candidates are adults (≥18) with radiologically confirmed hip fractures who are medically stable (ASA 1–4), able to consent and report pain, and willing to receive a peripheral nerve block.
Not a fit: Patients with altered mental status limiting pain reporting, allergy or contraindication to the block medications, or chronic preoperative opioid use are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, the PENG block could provide better pain control with lower opioid requirements and faster mobilization after hip fracture.
How similar studies have performed: Early case series and a randomized comparison to placebo have shown meaningful pain reductions with the PENG block, while femoral blocks have established benefits versus placebo in multiple studies and a Cochrane review.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Male or female ≥ 18 years of age. 2. ASA Classification 1-4 3. Documentation of a hip fracture diagnosis along with radiologic read indicating fracture location 4. Written, informed consent for analgesic peripheral block placement Exclusion Criteria: 1. Altered mental status to the extent that it limits ability to report pain score 2. Patient or health care proxy refusal of analgesic nerve block 3. Allergy to study medications or contraindication to peripheral nerve block 4. Chronic pain diagnosis on preoperative opioids
Where this trial is running
Manhattan, New York
- Weill Cornell Medicine — Manhattan, New York, United States (Recruiting)
Study contacts
- Principal investigator: Tiffany Tedore, MD — Weill Medical College of Cornell University
- Study coordinator: Michele Steinkamp, BSN, RN
- Email: mls9004@med.cornell.edu
- Phone: 212-746-2953
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.