Pericapsular Nerve Group Block Versus Femoral Nerve Block Study

NCT07717463 | Recruiting

• 1 other identifier: E-48670771-514.99-317908988
• Study Type: interventional
• Target: 110
• Locations: 1 country
• Sites: 2

Brief Summary

Hip fractures are common in older adults and are often associated with severe pain, making it difficult for patients to sit for spinal anesthesia before surgery. Peripheral nerve blocks may improve pain control and facilitate patient positioning, but it remains uncertain whether the Pericapsular Nerve Group (PENG) block provides advantages over the traditional femoral nerve block during the spinal anesthesia procedure.

Conditions

Hip Fractures

Keywords

Hip Fracture; Pericapsular Nerve Group Block; Femoral Nerve Block; Regional Anesthesia; Spinal Anesthesia; Hemodynamic Stability

Outcome Measures

Primary Outcomes (1)

• Spinal Anesthesia Convenience Score (SACS)

  Spinal anesthesia convenience will be assessed using the Spinal Anesthesia Convenience Score (SACS), a composite clinical score evaluating the ease of spinal anesthesia based on anatomical landmark palpation, patient cooperation, sitting position quality, pain during passive hip flexion, and pain while maintaining the sitting position. Total scores range from 0 to 11, with higher scores indicating easier spinal anesthesia conditions.

  During spinal anesthesia procedure (immediately after patient positioning and before initiation of surgery)

Secondary Outcomes (11)

• First-Attempt Success of Spinal Anesthesia

  During the spinal anesthesia procedure.

• Number of Spinal Needle Insertion Attempts

  During the spinal anesthesia procedure.

• Duration of Spinal Anesthesia Procedure

  During the spinal anesthesia procedure.

• Anxiety Score

  Before peripheral nerve block, 30 minutes after block placement, and immediately before surgical incision (after spinal anesthesia).

• Patient Satisfaction

  Postoperative Day 0 (before discharge from the post-anesthesia care unit [PACU])

Study Arms (2)

PENG Block

ACTIVE COMPARATOR

Participants will receive a preoperative ultrasound-guided Pericapsular Nerve Group (PENG) block with 20 mL of 0.25% bupivacaine before spinal anesthesia for proximal femur fracture surgery. Spinal anesthesia will subsequently be performed according to the standardized study protocol.

Procedure: Ultrasound-Guided Pericapsular Nerve Group (PENG) Block; Procedure: Spinal Anesthesia (bupivacaine)

Femoral Nerve Block

ACTIVE COMPARATOR

Participants will receive a preoperative ultrasound-guided femoral nerve block with 20 mL of 0.25% bupivacaine before spinal anesthesia for proximal femur fracture surgery. Spinal anesthesia will subsequently be performed according to the standardized study protocol.

Procedure: Ultrasound-Guided Femoral Nerve Block; Procedure: Spinal Anesthesia (bupivacaine)

Interventions

Ultrasound-Guided Femoral Nerve Block PROCEDURE

Ultrasound-guided femoral nerve block performed before spinal anesthesia using 20 mL of 0.25% bupivacaine to provide analgesia for patients undergoing surgery for proximal femur fracture.

Femoral Nerve Block

Ultrasound-Guided Pericapsular Nerve Group (PENG) Block PROCEDURE

Ultrasound-guided PENG block performed before spinal anesthesia using 20 mL of 0.25% bupivacaine to provide analgesia for patients undergoing surgery for proximal femur fracture.

PENG Block

Spinal Anesthesia (bupivacaine) PROCEDURE

Standard spinal anesthesia performed after the assigned peripheral nerve block using intrathecal hyperbaric bupivacaine according to the study protocol.

Femoral Nerve Block; PENG Block

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 50 years or older.
• Diagnosis of proximal femoral fracture.
• Scheduled to undergo surgical repair under spinal anesthesia.
• American Society of Anesthesiologists (ASA) physical status I-III.
• Able to provide written informed consent.

You may not qualify if:

• Refusal to participate or inability to provide informed consent.
• Coagulopathy or contraindication to spinal anesthesia or peripheral nerve block.
• Local infection at the planned injection site.
• Known allergy or hypersensitivity to local anesthetics.
• Pre-existing neurological disease affecting lower extremity function or sensory assessment.
• Cognitive impairment preventing reliable study participation or outcome assessment.
• Previous lumbar spine surgery.
• Polytrauma.
• Body mass index (BMI) \<18 kg/m² or \>40 kg/m².
• Current anticoagulant therapy that precludes neuraxial anesthesia or peripheral nerve block according to institutional practice.

Sponsors & Collaborators

• Taksim Egitim ve Arastirma Hastanesi: lead

Study Sites (2)

Taksim Training and Research Hospital

Istanbul, Beyoglu, Turkey (Türkiye)

NOT YET RECRUITING

Taksim Training and Research Hospital

Istanbul, Turkey (Türkiye)

RECRUITING

Related Publications (6)

• Messina A, La Via L, Milani A, Savi M, Calabro L, Sanfilippo F, Negri K, Castellani G, Cammarota G, Robba C, Morenghi E, Astuto M, Cecconi M. Spinal anesthesia and hypotensive events in hip fracture surgical repair in elderly patients: a meta-analysis. J Anesth Analg Crit Care. 2022 May 8;2(1):19. doi: 10.1186/s44158-022-00047-6.

  PMID: 37386657 RESULT

• Giron-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular Nerve Group (PENG) Block for Hip Fracture. Reg Anesth Pain Med. 2018 Nov;43(8):859-863. doi: 10.1097/AAP.0000000000000847.

  PMID: 30063657 RESULT

• Beaudoin FL, Nagdev A, Merchant RC, Becker BM. Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures. Am J Emerg Med. 2010 Jan;28(1):76-81. doi: 10.1016/j.ajem.2008.09.015.

  PMID: 20006206 RESULT

• Erten E, Kara U, Simsek F, Eskin MB, Bilekli AB, Ocal N, Senkal S, Ozdemirkan I. Comparison of pericapsular nerve group block and femoral nerve block in spinal anesthesia position analgesia for proximal femoral fractures in geriatric patients: a randomized clinical trial. Ulus Travma Acil Cerrahi Derg. 2023 Dec;29(12):1368-1375. doi: 10.14744/tjtes.2023.33389.

  PMID: 38073453 RESULT

• Lin DY, Brown B, Morrison C, Kroon HM, Jaarsma RL. Pericapsular nerve group block results in a longer analgesic effect and shorter time to discharge than femoral nerve block in patients after hip fracture surgery: a single-center double-blinded randomized trial. J Int Med Res. 2022 Mar;50(3):3000605221085073. doi: 10.1177/03000605221085073.

  PMID: 35291842 RESULT

• Aygun H, Tulgar S, Yigit Y, Tasdemir A, Kurt C, Genc C, Bilgin S, Senoglu N, Koksal E. Effect of ultrasound-guided pericapsular nerve group (PENG) block on pain during patient positioning for central nervous blockade in hip surgery: a randomized controlled trial. BMC Anesthesiol. 2023 Sep 15;23(1):316. doi: 10.1186/s12871-023-02245-3.

  PMID: 37715173 RESULT

MeSH Terms

Conditions

Hip Fractures

Interventions

Dental Occlusion; Anesthesia, Spinal; Bupivacaine

Condition Hierarchy (Ancestors)

Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries

Intervention Hierarchy (Ancestors)

Dentistry; Dental Physiological Phenomena; Digestive System and Oral Physiological Phenomena; Anesthesia, Conduction; Anesthesia; Anesthesia and Analgesia; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Study Officials

• Celal Kaya

  Taksim Training and Research Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Celal Kaya, MD

CONTACT

90 5435176760; c.kaya47@hotmail.com

Study Design

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

Study Record Dates

• First Submitted: July 6, 2026
• First Posted: July 21, 2026
• Study Start: July 22, 2026
• Primary Completion (Estimated): December 14, 2026
• Study Completion (Estimated): December 22, 2026
• Last Updated: July 31, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (2)