Deep Subgluteal Block vs PENG Combined With LFCN Block for Analgesia After Hip Arthroplasty

NCT07770932 | Recruiting

• 1 other identifier: E-10840098-772.02-2965
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized, prospective study aims to compare the clinical efficacy of ultrasound-guided Deep Subgluteal Block (DSGB) versus Pericapsular Nerve Group (PENG) block combined with Lateral Femoral Cutaneous Nerve (LFCN) block for postoperative analgesia management in patients undergoing hip arthroplasty. A total of 60 patients scheduled for hip arthroplasty under general anesthesia will be randomly allocated into two equal groups of 30: Group DSG and Group PENG+LFCN. Total local anesthetic volume (30 mL) and active drug dose (75 mg bupivacaine) will be standardized across both groups to ensure rigorous blinding and high methodological quality. The primary outcome of the study is to compare total postoperative opioid (fentanyl) consumption within the first 24 hours. Secondary outcomes include postoperative pain scores evaluated via the Numerical Rating Scale (NRS) at rest and during movement, the presence and degree of quadriceps motor block, and opioid-related adverse effects (e.g., nausea, vomiting, pruritus).

Conditions

Postoperative Pain

Keywords

Deep Subgluteal Block PENG Block Lateral Femoral Cutaneous Nerve Block Hip Arthroplasty Nerve Block Opioid Consumption

Outcome Measures

Primary Outcomes (1)

• Cumulative Postoperative Opioid Consumption

  Total intravenous fentanyl consumption (in micrograms) delivered via patient-controlled analgesia (PCA) within the first 24 hours postoperatively.

  First 24 hours postoperatively

Secondary Outcomes (3)

• Postoperative Pain Scores

  Postoperative hours 0 (PACU), 2, 4, 8, 16, and 24

• Quadriceps Motor Strength

  Postoperative hours 2, 4, 8, 16, and 24

• Opioid-Related Adverse Effects

  First 24 hours postoperatively

Study Arms (2)

Group DSG

ACTIVE COMPARATOR

Patients will receive an ultrasound-guided Deep Subgluteal Block using a total of 30 mL of 0.25% bupivacaine (15 mL administered beneath the gluteus minimus muscle and 15 mL beneath the gluteus medius muscle).

Drug: 0.25% Bupivacaine for Deep Subgluteal Block

Group PENG+LCFN

ACTIVE COMPARATOR

Patients will receive an ultrasound-guided Pericapsular Nerve Group (PENG) block combined with a Lateral Femoral Cutaneous Nerve (LFCN) block. The PENG block will be performed with 20 mL of 0.25% bupivacaine. The LFCN block will be performed using a 10 mL volume consisting of 5 mL of 0.25% bupivacaine diluted with 5 mL of normal saline (0.9% NaCl), resulting in a final local anesthetic concentration of 0.125% bupivacaine at the LFCN site.

Drug: 0.25% and 0.125% Bupivacaine for PENG+LFCN Block

Interventions

0.25% Bupivacaine for Deep Subgluteal Block DRUG

Ultrasound-guided regional anesthesia. Patients receive 30 mL of 0.25% bupivacaine, divided as 15 mL beneath the gluteus minimus muscle and 15 mL beneath the gluteus medius muscle.

Group DSG

0.25% and 0.125% Bupivacaine for PENG+LFCN Block DRUG

Ultrasound-guided combination regional anesthesia. Patients receive a PENG block with 20 mL of 0.25% bupivacaine, combined with an LFCN block using 10 mL of 0.125% bupivacaine (5 mL of 0.25% bupivacaine diluted with 5 mL of 0.9% normal saline).

Group PENG+LCFN

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients scheduled for elective total or partial hip arthroplasty under general anesthesia
• American Society of Anesthesiologists (ASA) physical status I-III
• Aged between 18 and 80 years
• Able to understand the study procedures, give voluntary written informed consent, and operate a patient-controlled analgesia (PCA) device

You may not qualify if:

• Patient refusal or inability to provide informed consent
• Pre-existing peripheral neuropathy, cognitive impairment, or psychiatric disorders
• History of significant severe renal or hepatic failure
• Allergy or hypersensitivity to amide-type local anesthetics or opioids
• Infection, severe anatomic distortion, or previous surgery at the proposed block injection sites
• History of substance abuse or chronic opioid use (defined as daily opioid use for \> 3 months prior to surgery)

Sponsors & Collaborators

• Medipol University: lead

Study Sites (1)

Medipol Mega University Hospital

Istanbul, Bagcilar, 34214, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Bupivacaine

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Central Study Contacts

Yunus O Atalay, MD, Prof., DESAIC

CONTACT

+90 212 453 4800; yoatalay@medipol.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: The patient and the investigator assessing postoperative outcomes are blinded to the group allocation.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Anesthesiology

Model Details: Patients are randomly assigned to one of the two parallel groups to receive either ultrasound-guided Deep Subgluteal Block or a combination of PENG and LFCN blocks.

Study Record Dates

• First Submitted: August 13, 2026
• First Posted: August 18, 2026
• Study Start: August 1, 2026
• Primary Completion (Estimated): December 30, 2026
• Study Completion (Estimated): January 30, 2027
• Last Updated: August 18, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)