QLESP Block Versus PENG+LFCN Block for Total Hip Arthroplasty

NCT07771829 | Recruiting

• 1 other identifier: WHUH20260809
• Study Type: interventional
• Target: 136
• Locations: 1 country
• Sites: 1

Brief Summary

Total hip arthroplasty (THA) is a common surgery to replace damaged hip joints, but many patients experience significant pain after surgery, which can delay recovery and increase the need for strong pain medications (opioids). Nerve blocks are a technique where anesthetic medication is injected near specific nerves to reduce pain. This study compares two different ultrasound-guided nerve block techniques for pain control after THA: the QLESP block (a newer technique that targets two areas with a single injection) and the PENG block combined with the LFCN block (a currently used technique that targets nerves around the hip joint and the outer thigh). Participants in this study will be randomly assigned (like a coin flip) to receive either the QLESP block or the PENG+LFCN block after surgery. The study aims to determine which nerve block provides better pain relief and reduces the need for opioid pain medications in the first 24 hours after surgery. Pain scores, recovery of leg movement, time to first walk, length of hospital stay, and any side effects will also be compared between the two groups.

Conditions

Pain Management; Arthroplasty Total Hip Replacement

Keywords

Total Hip Arthroplasty; Nerve Block; Postoperative Analgesia; QLESP Block; PENG Block

Outcome Measures

Primary Outcomes (1)

• Postoperative 24-Hour Cumulative Opioid Consumption

  At 24 hours after surgery

Secondary Outcomes (7)

• Postoperative VAS Pain Scores

  At 6, 12, 24, 36, and 48 hours after surgery

• Rescue Analgesia Requirement

  Within 24 hours after surgery

• Motor Block Assessment (Bromage Score)

  At 6, 24, and 48 hours after surgery

• Time to First Ambulation

  From surgery end to first walk, up to 7 days

• Length of Hospital Stay

  From surgery date to discharge, up to 30 days

Study Arms (2)

QLESP Group

EXPERIMENTAL

Participants receive ultrasound-guided QLESP block with 30 mL of 0.375% ropivacaine (15 mL between the erector spinae and transverse process, and 15 mL between the quadratus lumborum and psoas major).

Procedure: QLESP Block; Drug: ropivacaine

PENG+LFCN Group

ACTIVE COMPARATOR

Participants receive ultrasound-guided PENG block with 20 mL of 0.375% ropivacaine combined with LFCN block with 10 mL of 0.375% ropivacaine.

Procedure: PENG+LFCN Block; Drug: ropivacaine

Interventions

QLESP Block PROCEDURE

Ultrasound-guided quadratus lumborum and modified erector spinae plane block. A single-puncture, dual-injection technique at the L4 level. Total volume: 30 mL of 0.375% ropivacaine.

QLESP Group

PENG+LFCN Block PROCEDURE

Ultrasound-guided pericapsular nerve group block combined with lateral femoral cutaneous nerve block. PENG: 20 mL of 0.375% ropivacaine; LFCN: 10 mL of 0.375% ropivacaine.

PENG+LFCN Group

ropivacaine DRUG

Ropivacaine hydrochloride injection, 0.375% solution, administered as a single dose via ultrasound-guided nerve block. Total dose: 112.5 mg (30 mL of 0.375% solution) for the QLESP group; 112.5 mg (30 mL of 0.375% solution) for the PENG+LFCN group.

PENG+LFCN Group; QLESP Group

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 to 70 years
• Scheduled for elective unilateral total hip arthroplasty via posterolateral approach
• American Society of Anesthesiologists (ASA) physical status I-III
• Body mass index (BMI) \< 35 kg/m²
• Ability to understand pain scoring and patient-controlled analgesia (PCA) use
• Willing and able to provide written informed consent

You may not qualify if:

• Allergy or hypersensitivity to local anesthetics (ropivacaine)
• Long-term opioid use or chronic pain history requiring regular analgesic use
• Active malignancy or infection at the puncture site
• Severe psychiatric disorders or communication barriers
• Severe cardiopulmonary disease
• History of opioid abuse or substance dependence
• Participation in another interventional clinical trial within 3 months prior to enrollment
• Coagulation abnormalities
• Pregnancy or breastfeeding
• Any condition that, in the investigator's opinion, would compromise patient safety or data integrity

Sponsors & Collaborators

• Huazhong University of Science and Technology: lead

Study Sites (1)

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, 430022, China

RECRUITING

Related Publications (6)

• Tian Y, Lu Q, Yuan Y, Hu Z, Li W, Li K. The effect of pericapsular nerve group block and lateral femoral cutaneous nerve block on postoperative recovery after hip arthroplasty. Sci Rep. 2025 Jun 6;15(1):19913. doi: 10.1038/s41598-025-04699-6.

  PMID: 40481108 BACKGROUND

• Pascarella G, Costa F, Strumia A, Ruggiero A, Remore LM, Lanteri T, Hazboun A, Longo F, Gargano F, Schiavoni L, Mattei A, Agro FE, Carassiti M, Cataldo R. Lateral Femoral Cutaneous Nerve Block or Wound Infiltration Combined with Pericapsular Nerve Group (PENG) Block for Postoperative Analgesia following Total Hip Arthroplasty through Posterior Approach: A Randomized Controlled Trial. J Clin Med. 2024 May 2;13(9):2674. doi: 10.3390/jcm13092674.

  PMID: 38731203 BACKGROUND

• Liang L, Zhang C, Dai W, He K. Comparison between pericapsular nerve group (PENG) block with lateral femoral cutaneous nerve block and supra-inguinal fascia iliaca compartment block (S-FICB) for total hip arthroplasty: a randomized controlled trial. J Anesth. 2023 Aug;37(4):503-510. doi: 10.1007/s00540-023-03192-6. Epub 2023 Apr 12.

  PMID: 37043081 BACKGROUND

• Yang F, Tang Q, Wang B, Chen L. Pericapsular nerve group block combined with lateral femoral cutaneous nerve block for hip surgery: a meta-analysis. Front Pain Res (Lausanne). 2026 Jan 12;6:1723417. doi: 10.3389/fpain.2025.1723417. eCollection 2025.

  PMID: 41601711 BACKGROUND

• Vetrone F, Marelli S, Galimberti A, Umbrello M, Gotti M, Pezzi A, Girombelli A. Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial. J Pers Med. 2025 Jun 3;15(6):230. doi: 10.3390/jpm15060230.

  PMID: 40559093 BACKGROUND

• Hay E, Kelly T, Wolf BJ, Hansen E, Brown A, Lautenschlager C, Wilson SH. Comparison of pericapsular nerve group and lateral quadratus lumborum blocks on cumulative opioid consumption after primary total hip arthroplasty: a randomized controlled trial. Reg Anesth Pain Med. 2026 Jan 5;51(1):69-75. doi: 10.1136/rapm-2024-105875.

  PMID: 39389587 BACKGROUND

MeSH Terms

Conditions

Agnosia

Interventions

Ropivacaine

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Central Study Contacts

Xi Wu

CONTACT

+8615871715431; wu2018whuh@163.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Participants are randomly assigned in a 1:1 ratio to receive either QLESP block or PENG combined with LFCN block

Study Record Dates

• First Submitted: August 10, 2026
• First Posted: August 18, 2026
• Study Start: August 19, 2026
• Primary Completion (Estimated): February 15, 2027
• Study Completion (Estimated): February 28, 2027
• Last Updated: September 29, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)