Comparison of Pericapsular Nerve Group+ Lateral Femoral Cutaneous Nerve Block Versus Lumbar Erector Spinae Plane Block in Hip Arthroplasty Surgery

NCT07445009 | Completed

• 1 other identifier: FSMTRH-EDA-01
• Study Type: observational
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

Hip replacement surgery (partial or total hip arthroplasty) is commonly performed in elderly patients and is associated with significant postoperative pain. Effective pain management is critical to support early mobilization, reduce complications, shorten hospital stay, and prevent postoperative delirium.This observational study evaluates the effect of two ultrasound-guided regional analgesia approaches on postoperative pain and recovery quality in patients aged 65 years and older undergoing hip arthroplasty under general anesthesia: Group 1: Pericapsular Nerve Group (PENG) block + Lateral Femoral Cutaneous Nerve (LFCN) block Group 2: PENG block + Lumbar Erector Spinae Plane (ESP) block Both techniques are applied as part of routine clinical practice at our institution. The primary outcome is quality of recovery assessed by the QoR-15 questionnaire at 24 hours after surgery. Secondary outcomes include postoperative opioid consumption, pain scores (NRS), incidence of postoperative delirium (NU-DESC), nausea and vomiting, and time to mobilization. Patients are also followed up by telephone at postoperative day 7 and day 30 for mortality and morbidity assessment.

Conditions

Hip Arthroplasty; Postoperative Pain; Hip Fractures; Postoperative Delirium (POD)

Keywords

PENG block; Erector Spinae Plane Block; Lateral Femoral Cutaneous Nerve Block; Regional Analgesia; QoR-15; Quality of Recovery; Multimodal Analgesia; Hip Arthroplasty

Outcome Measures

Primary Outcomes (1)

• Quality of Recovery (QoR-15 Score)

  Quality of postoperative recovery assessed using the 15-item Quality of Recovery scale (QoR-15). Scores range from 0 to 150, with higher scores indicating better recovery quality. Scores are categorized as excellent (\>135), good (122-135), moderate (90-121), or poor (\<90). Baseline (preoperative) and postoperative 24-hour scores are compared between groups.

  24 hours after surgery

Secondary Outcomes (7)

• Postoperative Pain Score at Rest

  At 0, 15, 30 minutes in PACU and at 2, 4, 6, 12, 24 hours postoperatively

• Postoperative Pain Score on Movement

  At 0, 15, 30 minutes in PACU and at 2, 4, 6, 12, 24 hours postoperatively

• Total Tramadol Consumption

  24 hours after surgery

• Time to First Rescue Analgesic

  24 hours after surgery

• Incidence of Postoperative Delirium

  At 2, 4, 6, 12, 24 hours postoperatively

Study Arms (2)

PENG + LFCN Block

Patients who received ultrasound-guided Pericapsular Nerve Group (PENG) block (20 ml 0.25% bupivacaine) combined with Lateral Femoral Cutaneous Nerve (LFCN) block (5 ml 0.25% bupivacaine) at the end of surgery for postoperative analgesia.

Procedure: PENG + LFCN Block

PENG + ESP Block

Patients who received ultrasound-guided Pericapsular Nerve Group (PENG) block (20 ml 0.25% bupivacaine) combined with Lumbar Erector Spinae Plane (ESP) block (20 ml 0.25% bupivacaine) at the end of surgery for postoperative analgesia.

Procedure: PENG + Lumbar ESP Block

Interventions

PENG + LFCN Block PROCEDURE

Ultrasound-guided Pericapsular Nerve Group (PENG) block with 20 ml 0.25% bupivacaine combined with Lateral Femoral Cutaneous Nerve (LFCN) block with 5 ml 0.25% bupivacaine, applied at the end of surgery.

PENG + LFCN Block

PENG + Lumbar ESP Block PROCEDURE

Ultrasound-guided Pericapsular Nerve Group (PENG) block with 20 ml 0.25% bupivacaine combined with Lumbar Erector Spinae Plane (ESP) block with 20 ml 0.25% bupivacaine, applied at the end of surgery.

PENG + ESP Block

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Elderly patients (≥65 years) undergoing elective partial or total hip arthroplasty under general anesthesia at Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

You may qualify if:

• Age 65 years or older
• ASA physical status I-III
• Scheduled for elective partial or total hip arthroplasty under general anesthesia
• Mini-Mental State Examination (MMSE) score ≥24
• Written informed consent obtained

You may not qualify if:

• MMSE score below 24
• Refusal to participate
• Known allergy to local anesthetics or study medications
• Coagulation disorders or anticoagulant use contraindicating regional block
• Infection at the block site
• Pre-existing chronic pain conditions requiring opioid therapy
• ASA physical status IV or above

Sponsors & Collaborators

• Fatih Sultan Mehmet Training and Research Hospital: lead

Study Sites (1)

Istanbul Provincial Health Directorate Fatih Sultan Mehmet Training and Research Hospital

Istanbul, 34000, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative; Hip Fractures; Emergence Delirium

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries; Delirium; Confusion; Neurobehavioral Manifestations; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Study Officials

• eda eseroglu gulsen, MD

  Fatih Sultan Mehmet Training and Research Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 25, 2026
• First Posted: March 3, 2026
• Study Start: July 1, 2024
• Primary Completion: September 1, 2025
• Study Completion: October 1, 2025
• Last Updated: March 6, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)