PENG vs. FIC Block for Hip Fracture ED Patients

NCT05102760 | Active Not Recruiting

• 1 other identifier: 2021-02-09
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

Ultrasound-guided nerve blocks are an important tool for treating pain due to orthopedic injury in the ED. They provide long lasting, opioid-sparing pain relief that is generally safe and well-tolerated by patients1. Elderly patients with hip fractures commonly present to the ED, and their injury can be painful. Commonly used opioid pain regimens can have deleterious side effects, especially in elderly patients, like somnolence, delirium, hypotension and respiratory depression. The fascia iliaca compartment (FIC) block has become a familiar technique to emergency physicians as a pain control treatment for hip fractures. The pericapsular nerve group (PENG) block has recently been proposed as a novel method to treat pain due to hip, acetabular and pelvic fracture by targeting the terminal sensory articular nerve branches of the femoral nerve (FN), obturator nerve (ON), and accessory obturator nerve (AON). At this time there has been no study comparing the efficacy of the two nerve blocks, PENG and FIC. This aim of this study is to compare the efficacy of the PENG block (20mL of Bupivacaine 0.50%) to that of the FIC block (40mL of Bupivacaine 0.25%) for patients with hip fractures in the ED. Our hypothesis is that PENG will demonstrate analgesia that is non-inferior to FIC. Subjective pain scores on a scale of 0 to 10 will be assessed before and after the block. All subjects will receive 4mg of morphine after consent and prior to the block.

Conditions

Pain; Hip Fracture

Keywords

Pain; Hip Fracture; Nerve Block; Ultrasound

Outcome Measures

Primary Outcomes (1)

• Pain Score at 30 Minutes

  The pain score at 11 point Likert Scale ranging 0 (no pain) to 10 (very severe pain) at 30 minutes post nerve block procedure

  30 minutes post administration of nerve block

Secondary Outcomes (1)

• Pain Score at 60 minutes

  60 minutes post administration of nerve block

Study Arms (2)

Fascia Iliaca Compartment

ACTIVE COMPARATOR

Fascial Iliaca block (FIC) (40mL of Bupivacaine 0.25%) for patients with hip fractures in the ED

Procedure: Nerve Block using FIC Proceedure

PENG Block

ACTIVE COMPARATOR

Pericapsular Nerve Group (PENG) Block (20mL of Bupivacaine 0.50%)

Procedure: Nerve Block using PENG Proceedure

Interventions

Nerve Block using FIC Proceedure PROCEDURE

Ultrasound Guided Nerve Block for Hip Fracture Patients using the FIC Proceedure

Fascia Iliaca Compartment

Nerve Block using PENG Proceedure PROCEDURE

Ultrasound Guided Nerve Block for Hip Fractures Patients using the PENG Procedure

PENG Block

Eligibility Criteria

• Age: 18 Years - 110 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult Emergency Medicine Patients over 18 years of age
• Isolated hip fracture, intertrocanteric or more proximal
• Pain score 5 or greater on a scale of 0 to 10 just prior to nerve block placement

You may not qualify if:

• Patients with multi-system trauma
• People who are unable to communicate their level of pain\\
• Pregnant patients
• Pediatric Patients (less than 18 years of age)
• Intoxicated Patients
• Abnormal Vital Signs (HR\>120bpm, MAP \<65, Pulse Ox \<95%)
• Patients on long term systemic opioid analgesia
• Allergy to amide local anesthetics

Sponsors & Collaborators

• Antonios Likourezos: lead

Study Sites (1)

Maimonides Medical Center

Brooklyn, New York, 11209, United States

Location

MeSH Terms

Conditions

Pain; Hip Fractures

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries

Study Officials

• Lawrence Haines, MD

  Maimonides Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Research Administration Director

Study Record Dates

• First Submitted: October 20, 2021
• First Posted: November 2, 2021
• Study Start: October 20, 2021
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: September 25, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)