Comparison of Quadroiliac Plane Block and Pericapsular Nerve Group (PENG) Block in Femoral Fractures

NCT06604806 | Completed

• 1 other identifier: QIP-PFN
• Study Type: interventional
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective, multicenter study will compare the postoperative analgesic efficacy of the Quadroiliac Plane Block (QIPB) and Pericapsular Nerve Group (PENG) block in patients undergoing femoral neck fracture surgery. Eligible patients will be randomly assigned to receive one of the blocks postoperatively under spinal anesthesia. The blocks will be administered by experienced anesthesiologists, and informed consent will be obtained from all participants. Pain levels will be assessed using the visual analog scale (VAS) at rest and during movement at 0, 6, 12, and 24 hours post-surgery. Opioid consumption will be recorded through patient-controlled analgesia (PCA), and any need for rescue analgesia will be evaluated. Routine postoperative pain management will also include intravenous paracetamol.

Conditions

Femur Fractures

Keywords

postoperative pain management; fascial plan blocks; pain; analgesia

Outcome Measures

Primary Outcomes (1)

• opioid consumption

  Opioid consumption in 24 hours will compared between these two block

  1 day

Secondary Outcomes (1)

• Visual Analogue Scale

  1 day

Study Arms (2)

opioid consumption

ACTIVE COMPARATOR

opioid consumption of the patients in patient controlled analgesia device

Procedure: PENG Block; Procedure: Quadro-Iliac plane block

Visual Analogue Scale scores of the patients

ACTIVE COMPARATOR

Visual Analogue Scale scores of the patients

Procedure: PENG Block; Procedure: Quadro-Iliac plane block

Interventions

PENG Block PROCEDURE

With the patient in the supine position, the ultrasound probe is placed transversely over the anterior superior iliac spine (ASIS). After identifying the ASIS, the transducer is aligned with the pubic ramus and rotated approximately 45 degrees to become parallel to the inguinal crease. The transducer is moved medially until the anterior inferior iliac spine (AIIS), iliopubic eminence (IPE), and psoas tendon are clearly visualized as anatomical landmarks. After confirming the correct location with saline injection, 50 mg of 0.25% bupivacaine will be administered.

Visual Analogue Scale scores of the patients; opioid consumption

Quadro-Iliac plane block PROCEDURE

With the patient in the prone position, a low-frequency convex transducer (2-6 MHz) and a 22G x 100 mm peripheral nerve block needle (Stimuplex® Ultra 360®, B-Braun) will be used. The transducer will be placed transversely at the L3 level to identify the spinal processes, followed by lateral movement to visualize the transverse process within the erector spinae muscle. The transducer will then be rotated parasagittally and moved caudally to locate where the Quadratus Lumborum muscle (QLM) attaches to the iliac crest. After confirming the location with saline, 50 mg of 0.25% bupivacaine will be administered under the fascia of the QLM.

Visual Analogue Scale scores of the patients; opioid consumption

Eligibility Criteria

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

You may qualify if:

• Patients and their relatives have provided informed consent,
• Patients aged 18 years or older undergoing femoral fracture surgery,
• ASA score of I-III,
• No history of bleeding diathesis,
• No history of anticoagulant use that contraindicates block application according to guidelines,
• No history of neuropathic diseases such as Diabetes Mellitus,
• No known allergy to local anesthetics.

You may not qualify if:

• Lack of informed consent from the patient or their relatives,
• Development of complications during the surgical procedure,
• Need for revision surgery,
• Patient\'s desire to withdraw from the study,
• Patients under the age of 18,
• ASA score of IV or higher,
• Patients with a history of bleeding diathesis,
• History of anticoagulant use that contraindicates block application according to guidelines,
• Emergency surgeries,
• History of allergy to local anesthetics,
• History of neuropathic diseases,
• Inability to comply with patient-controlled analgesia (PCA) systems.

Sponsors & Collaborators

• Kanuni Sultan Suleyman Training and Research Hospital: lead

Study Sites (1)

Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital

Istanbul, Istanbul, 34303, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Femoral Fractures; Pain; Agnosia

Condition Hierarchy (Ancestors)

Fractures, Bone; Wounds and Injuries; Leg Injuries; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: M.D.

Study Record Dates

• First Submitted: September 17, 2024
• First Posted: September 20, 2024
• Study Start: October 1, 2024
• Primary Completion: September 1, 2025
• Study Completion: September 15, 2025
• Last Updated: November 18, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)