Comparative Study Between Pericapsular Nerve Group Block (PENG) And Pericapsular Nerve Group (PENG) Block Combined With Lateral Femoral Cutaneous Nerve (LFCN) Block for Positioning Analgesia Prior to Spinal Anesthesia in Hip Fracture Patients

NCT07687290 | Recruiting

• 1 other identifier: FMASU MS 25 / 2026
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

To evaluate and compare the effectiveness of the Pericapsular Nerve Group (PENG) block alone versus the PENG block combined with the Lateral Femoral Cutaneous Nerve (LFCN) block in providing adequate analgesia for patient positioning during spinal anesthesia in individuals undergoing surgery for hip fracture.

Conditions

Hip Fracture Surgeries

Keywords

hip surgeries; positioning for spinal anesthesia; PENG block; LCFN block

Outcome Measures

Primary Outcomes (1)

• To compare the time taken to achieve optimal positioning for spinal anesthesia in both groups

  time taken in seconds for positioning for spinal anesthesia 15 minutes post- block

  from initiation of patient positioning until optimal positioning is achieved during the spinal anesthesia procedure

Secondary Outcomes (4)

• To assess Numerical Rating Pain Score in both groups at 0,5,10 and 15 minutes post block

  at baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block

• To assess patient satisfaction and comfort during positioning using Likert scale

  during patient positioning 15 minutes after completion of the block

• To monitor mean arterial blood pressure

  at baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block

• To monitor heart rate

  At baseline (0 minutes) and at 5,10 and 15 minutes after completion of the block

Study Arms (2)

group A (PENG BLOCK)

ACTIVE COMPARATOR

The patient is positioned supine and hip extended. 3 mL of 2% lidocaine is injected at the insertion site using a hyperechoic needle guided by ultrasound using a low-frequency probe. At the anterior superior iliac spine level, the probe is placed parallel to the inguinal fold, and scanning is performed with a gradual movement of the probe head. When the lower anterior inferior iliac spine is observed, the probe is rotated slightly median until a continuous hyperechoic shadow of the upper pubic ramus is visible. This maneuver help to identify the psoas muscle with a prominent tendon above the pubic ramus. The target is located in the plane between these 2 structures. The pubic ramus should be aligned in the center of the image to target the pubic ramus just inside the anterior inferior iliac spine. A 100-mm nerve block needle can be introduced, and 20 ml of 0.25% of Bupivacaine (10 ml of Bupivacaine 0.5% is added to 10ml of Lidocaine 2%) is administered

Procedure: PENG Block; Drug: bupivacaine 0.25%.; Drug: Xylocaine 2 %

Group B (PENG block and LCFN block)

ACTIVE COMPARATOR

in addition to PENG block ( as described before), LFCN block is performed by using a linear array ultrasound probe a cross-sectional view of the LFCN was obtained by identifying the anterior superior iliac spine, then the probe is moved in a medial and caudal direction until the nerve was encountered. The needle was advanced to the LFCN under ultrasound guidance via a lateral to medial approach. Injection of 8ml of 0.25% of Bupivacaine (4 ml of Bupivacaine 0.5% is added to 4 ml of Lidocaine 2%)

Procedure: PENG Block; Procedure: LCFN block; Drug: bupivacaine 0.25%.; Drug: Xylocaine 2 %

Interventions

PENG Block PROCEDURE

Pericapsular Nerve Group Block

Group B (PENG block and LCFN block); group A (PENG BLOCK)

LCFN block PROCEDURE

Lateral Femoral Cutaneous Nerve block

Group B (PENG block and LCFN block)

bupivacaine 0.25%. DRUG

0.25% of Bupivacaine (Bupivacaine 0.5% is added to Lidocaine 2% in the same volume)

Group B (PENG block and LCFN block); group A (PENG BLOCK)

Xylocaine 2 % DRUG

local infilteration at the insertion site

Group B (PENG block and LCFN block); group A (PENG BLOCK)

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18-70 years.
• ASA I-II.
• Confirmed primary unilateral hip fracture.
• Scheduled for surgery under spinal anesthesia.
• Patients able to provide informed consent.

You may not qualify if:

• Allergy to local anesthetics.
• Coagulopathy or on anticoagulant therapy.
• Infection at injection site.
• Pre-existing neurological deficits in the lower limbs.
• Multiple trauma or polytrauma (If other injuries might interfere with positioning or pain scoring).
• Previous surgery on the ipsilateral hip affecting anatomy or nerve distribution.

Sponsors & Collaborators

• Ain Shams University: lead

Study Sites (1)

Ain Shams University

Cairo, Egypt

RECRUITING

MeSH Terms

Interventions

Lidocaine

Intervention Hierarchy (Ancestors)

Acetanilides; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Central Study Contacts

Maha Salah, lecturer

CONTACT

+201007269331; mahata5deer@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principal investigator

Study Record Dates

• First Submitted: June 18, 2026
• First Posted: July 7, 2026
• Study Start: June 18, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: July 9, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)