Sacral ESPB versus PENG nerve block for pain after hip hemiarthroplasty

Sacral Erector Spinae Plane Block Versus Pericapsular Nerve Group Block For Analgesia In Hip Hemi Arthroplasty: A Randomized Comparative Study

We will see if a sacral erector spinae plane (S-ESPB) block or a pericapsular nerve group (PENG) block gives better pain relief for adults 50–90 having hip hemiarthroplasty for a femoral neck fracture.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 80 (estimated)
• Ages: 50 Years to 90 Years
• Sex: All
• Sponsor: Fayoum University Hospital (other)
• Locations: 1 site (El Fayoum Qesm, Faiyum Governorate)
• Trial ID: NCT07442721 on ClinicalTrials.gov

What this trial studies

This is a double-blinded, randomized, parallel-group study at Fayoum University Hospital enrolling 80 patients aged 50–90 with intracapsular femoral neck fractures scheduled for elective hip hemiarthroplasty. Patients are randomized 1:1 to receive either a sacral erector spinae plane (S-ESPB) block or a pericapsular nerve group (PENG) block before surgery, with allocation concealed by opaque sealed envelopes. The patient, the data collector, and the outcome assessor are blinded to group assignment while blocks and equipment are prepared by independent personnel. Postoperative pain scores, opioid consumption, and motor function will be compared between the two groups.

Who should consider this trial

Good fit: Adults aged 50–90 with intracapsular femoral neck fractures scheduled for elective hip hemiarthroplasty and with ASA physical status I–III are the intended participants.

Not a fit: Patients with contraindications such as coagulopathy, infection at the injection site, BMI >35 kg/m2, peripheral or diabetic neuropathy, chronic opioid therapy, cognitive impairment, bilateral hip fracture, prior ipsilateral hip surgery, allergy to local anesthetics, or contraindication to spinal anesthesia are excluded and unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, one block approach could offer better pain control with less motor impairment and lower opioid requirements after hip hemiarthroplasty.

How similar studies have performed: PENG block has clinical studies showing anterior hip analgesia but can be associated with motor weakness, while sacral ESPB currently has mainly case reports and is less well studied for hip surgery.

Eligibility criteria

Inclusion Criteria:

* Patients with ages from 50 to 90 years of either gender, with diagnosis of intracapsular neck of femur fracture scheduled for elective hip hemiarthroplasty • Patients with an American Society of Anesthesiologists (ASA) physical status I to III.

Exclusion Criteria:

* • Patient refusal.

  * Allergy to local anesthetics and patient with infection at the injection site of block
  * Patient with contraindication to spinal anesthesia.
  * Coagulopathy as INR≥1.5 or platelets ≤80\*103 / microliter)
  * Patients with body mass index\>35 kg / m2
  * Patients with peripheral neuropathy or diabetic neuropathy
  * Patients receiving opioids for chronic analgesic therapy (cancer, addiction).
  * Cognitive impairment preventing pain scoring.
  * Chronic renal failure requiring dose modification.
  * Bilateral hip fracture or previous ipsilateral hip surgery

Where this trial is running

El Fayoum Qesm, Faiyum Governorate

• Fayoum University hospita — El Fayoum Qesm, Faiyum Governorate, Egypt (RECRUITING)

Study contacts

• Study coordinator: Samar Ahmed Ramadan

Conditions: Hip Arthroplasty, Hip Fracture Surgeries, Femoral Neck Fractures, Postoperative Pain