Comparison of Spinal Anesthesia With Intrathecal Morphine Versus PENG Block With or Without Dexamethasone in Hip Arthroplasty

NCT07584200 | Not Yet Recruiting

• 1 other identifier: 1/2026
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to learn which of three regional anesthesia approaches provides better pain relief and safety for older adults having planned hip replacement surgery. Researchers will study people aged 60 years and older who are scheduled for elective total hip arthroplasty. The main questions this study aims to answer are: Which anesthesia method provides better pain control after surgery? Which method reduces the need for opioid pain medicines? Are there differences in side effects and recovery between the approaches? Participants will be randomly assigned to one of three groups. All participants will receive spinal anesthesia. One group will receive spinal anesthesia with intrathecal morphine. The other two groups will receive spinal anesthesia combined with a nerve block called the pericapsular nerve group (PENG) block, with or without the addition of dexamethasone. Participants will have their pain levels measured at regular times during the first two days after surgery. Researchers will also record opioid use, time to first pain medication, ability to move after surgery, length of hospital stay, and any side effects such as nausea or itching. Blood tests will be used to measure markers of inflammation. The results of this study may help doctors choose safer and more effective pain control strategies for people undergoing hip replacement surgery.

Conditions

Arthropathy of Hip; Hip Osteoarthritis

Keywords

total hip arthroplasty

Outcome Measures

Primary Outcomes (1)

• Total Postoperative Opioid Consumption

  Total amount of opioids administered postoperatively, expressed as intravenous morphine equivalents.

  Up to 48 hours after surgery

Secondary Outcomes (12)

• Pain scores at rest

  6 hours after surgery

• Pain scores durring movement

  6 hours after surgery

• Pain scores at rest

  12 hours after surgery

• Pain scores durring movement

  12 hours after surgery

• Pain scores at rest

  24 hours after surgery

Study Arms (3)

Spinal Anesthesia With Intrathecal Morphine

ACTIVE COMPARATOR

Participants will receive spinal anesthesia with intrathecal ropivacaine combined with intrathecal morphine. Ropivacaine 0.5% (10-15 mg) will be administered intrathecally, followed by intrathecal morphine at a dose of 100 micrograms as part of standard anesthesia care.

Drug: Intrathecal Morphine

Spinal Anesthesia Plus PENG Block

EXPERIMENTAL

Participants will receive spinal anesthesia with intrathecal ropivacaine 0.5% (10-15 mg) combined with an ultrasound-guided pericapsular nerve group (PENG) block. The PENG block will be performed using 20 mL of ropivacaine 0.2% administered as a single injection.

Procedure: Pericapsular Nerve Group Block

Spinal Anesthesia Plus PENG Block With Dexamethasone

EXPERIMENTAL

Participants will receive spinal anesthesia with intrathecal ropivacaine 0.5% (10-15 mg) combined with an ultrasound-guided pericapsular nerve group (PENG) block. The PENG block will be performed using 20 mL of ropivacaine 0.2% with the addition of dexamethasone 4 mg administered perineurally as a single injection.

Drug: Dexamethasone

Interventions

Intrathecal Morphine DRUG

Intrathecal morphine administered as part of spinal anesthesia for postoperative pain control during elective total hip arthroplasty.

Also known as: Morphine (intrathecal)

Spinal Anesthesia With Intrathecal Morphine

Pericapsular Nerve Group Block PROCEDURE

Ultrasound-guided pericapsular nerve group block performed as an adjunct to spinal anesthesia to provide postoperative analgesia.

Also known as: PENG Block

Spinal Anesthesia Plus PENG Block

Dexamethasone DRUG

Perineural dexamethasone administered as an adjuvant to the pericapsular nerve group block to prolong postoperative analgesia.

Also known as: Dexamethasone (perineural)

Spinal Anesthesia Plus PENG Block With Dexamethasone

Eligibility Criteria

• Age: 60 Years - 100 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 60 to 100 years
• Scheduled for elective total hip arthroplasty
• American Society of Anesthesiologists (ASA) physical status I-III
• Ability to understand the study procedures and provide written informed consent

You may not qualify if:

• Known allergy or hypersensitivity to ropivacaine, morphine, or dexamethasone
• Coagulation disorders or ongoing anticoagulant therapy contraindicating spinal anesthesia or regional nerve blocks
• Infection at the site of spinal or peripheral nerve block injection
• Pre-existing neurological disorders affecting sensory or motor function
• Severe hepatic or renal insufficiency
• Chronic opioid use for more than 3 months prior to surgery
• Refusal or inability to provide informed consent

Sponsors & Collaborators

• Poznan University of Medical Sciences: lead

Study Sites (1)

Poznan University of Medical Sciences

Poznan, 62-701, Poland

Location

MeSH Terms

Conditions

Osteoarthritis, Hip

Interventions

Morphine; Dexamethasone

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Intervention Hierarchy (Ancestors)

Morphine Derivatives; Morphinans; Opiate Alkaloids; Alkaloids; Heterocyclic Compounds; Heterocyclic Compounds, Bridged-Ring; Heterocyclic Compounds, 4 or More Rings; Heterocyclic Compounds, Fused-Ring; Phenanthrenes; Polycyclic Aromatic Hydrocarbons; Polycyclic Compounds; Pregnadienetriols; Pregnadienes; Pregnanes; Steroids; Fused-Ring Compounds; Steroids, Fluorinated

Study Officials

• Malgorzata Reysner, MD PhD

  Poznań University of Medical Sciences

  STUDY CHAIR

Central Study Contacts

Malgorzata Reysenr, MD PhD

CONTACT

608762068; mreysner@ump.edu.pl

Malgorzata Reysner, MD PhD

CONTACT

608762068; mreysner@ump.edu.pl

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 13, 2026
• First Posted: May 13, 2026
• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): March 31, 2027
• Study Completion (Estimated): May 1, 2027
• Last Updated: May 13, 2026

Record last verified: 2026-02

Locations

PL (1)