PENG Block With or Without PPD Block for Postoperative Analgesia After Total Hip Arthroplasty

NCT07502248 | Not Yet Recruiting

• 1 other identifier: KAEAH-THA-PENG-PPD-01
• Study Type: interventional
• Target: 40
• Locations: 0 countries
• Sites: N/A

Brief Summary

This single-center, prospective, randomized controlled clinical trial aims to compare the postoperative analgesic efficacy of PENG block with or without posterior pericapsular deep gluteal block in adult patients undergoing elective primary total hip arthroplasty under spinal anesthesia. Total hip arthroplasty is commonly associated with moderate to severe postoperative pain. Although PENG block provides analgesia for the anterior hip capsule, some patients may still experience pain originating from the posterior capsule. The addition of PPD block may improve analgesia by targeting posterior articular branches. Participants will be randomized into two groups: one group will receive PENG block, and the other group will receive PENG plus PPD block. Postoperative pain will be assessed using the Numeric Rating Scale (NRS). The study will compare postoperative pain scores and other analgesia-related outcomes between groups.

Conditions

Postoperative Pain; Total Hip Arthroplasty (THA)

Keywords

PENG block; PPD block; Postoperative analgesia; Numeric Rating Scale

Outcome Measures

Primary Outcomes (1)

• Postoperative pain intensity at 6 hours measured by Numeric Rating Scale (NRS)

  Postoperative pain intensity will be assessed using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. The primary comparison between groups will be the NRS score at postoperative 6 hours

  6 hours after surgery

Secondary Outcomes (5)

• Postoperative pain intensity over the first 24 hours measured by Numeric Rating Scale (NRS)

  Recovery room, 2 hours, 12 hours, and 24 hours after surgery

• Total analgesic consumption during the first 24 hours

  24 hours after surgery

• Time to first rescue analgesic requirement

  Up to 24 hours after surgery

• Time to first mobilization

  Up to 24 hours after surgery

• Ankle dorsiflexion motor strength

  Recovery room, 2 hours, 6 hours, 12 hours, and 24 hours after surgery

Study Arms (2)

PENG Block

ACTIVE COMPARATOR

Participants in this arm will receive ultrasound-guided PENG block after spinal anesthesia for postoperative analgesia during primary total hip arthroplasty. In addition, lateral femoral cutaneous nerve block will be performed.

Procedure: PENG Block

PENG Plus PPD Block

ACTIVE COMPARATOR

Participants in this arm will receive ultrasound-guided PENG block followed by ultrasound-guided posterior pericapsular deep gluteal block after spinal anesthesia for postoperative analgesia during primary total hip arthroplasty. In addition, lateral femoral cutaneous nerve block will be performed.

Procedure: PENG Block; Procedure: Deep posterior gluteal compartment block

Interventions

PENG Block PROCEDURE

Ultrasound-guided pericapsular nerve group block performed after spinal anesthesia for postoperative analgesia in patients undergoing primary total hip arthroplasty. In Group 1, PENG block will be performed in the supine position using an in-plane technique, and 20 mL of 0.25% bupivacaine will be injected between the psoas tendon and iliopubic ramus. In both groups, lateral femoral cutaneous nerve block will also be performed as part of the analgesic protocol.

Also known as: Pericapsular Nerve Group Block

PENG Block; PENG Plus PPD Block

Deep posterior gluteal compartment block PROCEDURE

Ultrasound-guided posterior pericapsular deep gluteal block performed after PENG block and spinal anesthesia for postoperative analgesia in patients undergoing primary total hip arthroplasty. In Group 2, the block will be performed in the lateral decubitus position with the hip and knee flexed to 90 degrees, and 30 mL of 0.25% bupivacaine will be injected after needle placement to the posterior acetabular rim near the ischiofemoral ligament using an in-plane technique.

Also known as: PPD block

PENG Plus PPD Block

Eligibility Criteria

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

You may qualify if:

• Adults aged 18 years and older
• American Society of Anesthesiologists (ASA) physical status I-III
• Scheduled for elective primary total hip arthroplasty under spinal anesthesia
• Able to provide written informed consent

You may not qualify if:

• ASA physical status IV or V
• Serious concomitant cardiac, respiratory, hepatic, or renal disease
• Known neuropsychiatric disorder
• Cognitive impairment preventing understanding or response to the Numeric Rating Scale (NRS)
• Coagulopathy
• Local anesthetic allergy
• Infection or scar at the block site
• Failed block
• Refusal to participate
• Signs of local anesthetic systemic toxicity after block
• Patients in the PENG plus PPD group who would be exposed to a total local anesthetic dose above 3 mg/kg in patients weighing less than 50 kg
• Revision total hip arthroplasty
• Total hip arthroplasty planned for fracture

Sponsors & Collaborators

• Kirsehir Ahi Evran Universitesi: lead

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Guzin Ceran, MD

  Kirsehir Ahi Evran University Faculty of Medicine, Kirsehir Training and Research Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Guzin Ceran Assistant Professor, MD

CONTACT

+90-506-163-0936; gzncrn@hotmail.com

Abdulkadir Apaydin, MD

CONTACT

+90-531-951-2333; apydnkadir@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, Department of Anesthesiology and Reanimation

Study Record Dates

• First Submitted: March 25, 2026
• First Posted: March 30, 2026
• Study Start: April 5, 2026
• Primary Completion (Estimated): April 5, 2027
• Study Completion (Estimated): June 5, 2027
• Last Updated: March 30, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share