NCT07449403

Brief Summary

This randomized controlled trial evaluates the effect of ultrasound-guided Pericapsular Nerve Group (PENG) block on the Systemic Immune-Inflammation Index (SII) in elderly patients undergoing total hip arthroplasty under spinal anesthesia. SII, calculated as platelet × neutrophil / lymphocyte count, is used as a composite marker of perioperative inflammatory and immune response. The study investigates whether PENG block attenuates the systemic inflammatory reaction to surgical trauma compared to sham block.

Trial Health

65
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
0mo left

Started Apr 2026

Shorter than P25 for not_applicable

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress84%
Apr 2026Jun 2026

First Submitted

Initial submission to the registry

February 27, 2026

Completed
5 days until next milestone

First Posted

Study publicly available on registry

March 4, 2026

Completed
28 days until next milestone

Study Start

First participant enrolled

April 1, 2026

Completed
1 month until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2026

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2026

Expected
Last Updated

March 4, 2026

Status Verified

February 1, 2026

Enrollment Period

1 month

First QC Date

February 27, 2026

Last Update Submit

February 27, 2026

Conditions

Outcome Measures

Primary Outcomes (1)

  • Systemic Inflammation Response Index (SIRI)

    Systemic Inflammation Response Index (SIRI) is used as a composite marker of systemic inflammatory activation. It is calculated from peripheral venous blood samples using the formula: SIRI = (Neutrophil count × Monocyte count) / Lymphocyte count All parameters are obtained from routine complete blood count (CBC) analysis and expressed in ×10⁹/L. SIRI reflects the interaction between innate immune activation (neutrophils and monocytes) and adaptive immune suppression (lymphocytes). Higher SIRI values indicate greater systemic inflammatory response.

    12 hours after surgery

Secondary Outcomes (18)

  • Systemic Inflammation Response Index (SIRI)

    24 hours after surgery

  • Systemic Inflammation Response Index (SIRI)

    48 hours after surgery

  • Aggregate Index of Systemic Inflammation (AISI)

    12 hours after surgery

  • Aggregate Index of Systemic Inflammation (AISI)

    24 hours after surgery

  • Aggregate Index of Systemic Inflammation (AISI)

    48 hours after surgery

  • +13 more secondary outcomes

Study Arms (2)

Sham blocks

SHAM COMPARATOR

PENG block with 20ml of 0.9% sodium chloride

Drug: sodium Chloride

PENG block

ACTIVE COMPARATOR

PENG block with 20ml 0f 0.2% ropivacaine

Drug: Ropivacaine 0.2% Injectable Solution

Interventions

After spinal anesthesia, the ultrasound-guided PENG block will be performed with 20 ml of 0.2% ropivacaine

Also known as: 0.2% ropivacaine
PENG block

After spinal anesthesia, the ultrasound-guided PENG block will be performed with 20ml of 0.9% sodium chloride

Also known as: 0.9% Sodium Chloride Injection
Sham blocks

Eligibility Criteria

Age65 Years - 100 Years
Sexall
Healthy VolunteersNo
Age GroupsOlder Adult (65+)

You may qualify if:

  • Patients with ASA classification I-III
  • Aged 65-100 years
  • Who will be scheduled for hip arthroplasty under spinal anesthesia

You may not qualify if:

  • Patients who have a history of bleeding diathesis
  • Take anticoagulant therapy
  • History of chronic pain before surgery
  • Multiple trauma
  • patients unable to assess their pain (dementia)
  • patients operated under general anesthesia
  • patients having an infection in the region of the procedure
  • the patient who does not accept the procedure

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Osteoarthritis, Hip

Interventions

Sodium ChlorideRopivacaine

Condition Hierarchy (Ancestors)

OsteoarthritisArthritisJoint DiseasesMusculoskeletal DiseasesRheumatic Diseases

Intervention Hierarchy (Ancestors)

ChloridesHydrochloric AcidChlorine CompoundsInorganic ChemicalsSodium CompoundsAnilidesAmidesOrganic ChemicalsAniline CompoundsAmines

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 27, 2026

First Posted

March 4, 2026

Study Start

April 1, 2026

Primary Completion

May 1, 2026

Study Completion (Estimated)

June 30, 2026

Last Updated

March 4, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will share

De-identified individual participant data (IPD) underlying the results reported in publications (including demographic data, laboratory inflammatory indices such as SII, SIRI, AISI, CRP values, pain scores, opioid consumption, and time-to-event outcomes) will be made available to qualified researchers. Data will be shared after removal of all direct identifiers in accordance with GDPR regulations and institutional data protection policies. The study protocol, statistical analysis plan (SAP), and analytic code will also be available upon reasonable request. Data will be provided for the purpose of secondary analyses, meta-analyses, or validation studies, subject to approval by the principal investigator and institutional review board, where applicable.

Shared Documents
STUDY PROTOCOL, SAP, ANALYTIC CODE
Time Frame
Data will become available 6 months after publication of the primary results and will remain available for 5 years.
Access Criteria
Access will be granted to researchers who provide: A methodologically sound research proposal Institutional affiliation Ethical approval (if required) A signed data use agreement Requests should be directed to the principal investigator via institutional email.