Posterior Pericapsular Deep-gluteal Block

NCT07891013 | Not Yet Recruiting

• 1 other identifier: PPD Block
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical trial is to determine whether adding a posterior pericapsular deep-gluteal (PPD) block to pericapsular nerve group (PENG) and lateral femoral cutaneous nerve (LFCN) blocks improves pain control after total hip arthroplasty. The main questions it aims to answer are:

• Does adding a posterior pericapsular deep-gluteal block reduce clinically significant pain during movement in the early postoperative period?
• Does adding this block reduce postoperative pain and opioid requirements?
• Does adding this block improve functional recovery after surgery? Researchers will compare patients receiving PENG and LFCN blocks with patients receiving PENG and LFCN blocks plus a posterior pericapsular deep-gluteal block to determine whether blocking the posterior region of the hip provides additional pain relief. Participants will:
• Receive ultrasound-guided nerve blocks before surgery according to their assigned study group.
• Undergo total hip arthroplasty under spinal anesthesia.
• Have their pain assessed at predefined times after surgery, including during movement.
• Be evaluated for opioid requirements and functional recovery after surgery.

Conditions

Pain, Postoperative

Keywords

total hip arthroplasty; analgesia; pain; pericapsular nerve group (PENG) block; posterior pericapsular deep gluteal block; lateral femoral cutaneous (LFCN) block; regional anesthesia

Outcome Measures

Primary Outcomes (1)

• 6-hour dynamic pain intensity

  Dynamic pain will be assessed using the Numerical Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain).

  6 hours postoperatively

Secondary Outcomes (5)

• Dynamic pain intensity

  4, 8, 12, and 24 hours postoperatively

• Pain intensity at rest

  4, 6, 8, 12, and 24 hours postoperatively

• Cumulative morphine consumption

  Up to 24 hours postoperatively

• Time to first rescue analgesic

  Up to 24 hours postoperatively

• Quality of Recovery (QoR)-15 score

  Preoperatively and postoperative day 1

Other Outcomes (2)

• Patient satisfaction score

  Postoperative day 1

• Sleep quality score

  Postoperative day 1

Study Arms (2)

PENG+LFCN group

ACTIVE COMPARATOR

PENG block : 20 ml %0.25 Bupivacaine LFCN block: 5 ml %0.50 Bupivacaine

Procedure: PENG (Pericapsular nerve group) block; Procedure: LFCN (Lateral femoral cutaneous nerve) block

PENG+LFCN+PPD group

EXPERIMENTAL

PENG block: 20 ml %0.25 Bupivacaine LFCN block: 5 ml %0.50 Bupivacaine PPD block: 15 ml %0.25 Bupivacaine

Procedure: PENG (Pericapsular nerve group) block; Procedure: LFCN (Lateral femoral cutaneous nerve) block; Procedure: PPD (Posterior pericapsular deep gluteal) block

Interventions

PENG (Pericapsular nerve group) block PROCEDURE

An ultrasound-guided pericapsular nerve group (PENG) block will be performed in the preoperative period, approximately 30 minutes before surgery.

PENG+LFCN group; PENG+LFCN+PPD group

LFCN (Lateral femoral cutaneous nerve) block PROCEDURE

An ultrasound-guided lateral femoral cutaneous nerve (LFCN) block will be performed in the preoperative period, approximately 30 minutes before surgery.

PENG+LFCN group; PENG+LFCN+PPD group

PPD (Posterior pericapsular deep gluteal) block PROCEDURE

An ultrasound-guided posterior pericapsular deep-gluteal block will be performed in the preoperative period, approximately 30 minutes before surgery.

PENG+LFCN+PPD group

Eligibility Criteria

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

You may qualify if:

• Patients aged 18 years or older
• Patients scheduled for elective primary unilateral total hip arthroplasty
• American Society of Anesthesiologists (ASA) physical status I-III
• Patients who provide written informed consent to participate in the study

You may not qualify if:

• Cognitive impairment that may interfere with pain assessment or study participation
• Known allergy to local anesthetics
• Revision total hip arthroplasty
• Contraindication to spinal anesthesia
• Neuromuscular disease

Sponsors & Collaborators

• Ankara Etlik City Hospital: lead

Related Publications (5)

• Hu J, Wang Q, Hu J, Gong C, Yang J. A modified hip pericapsular nerve block on postoperative pain and functional outcome after total hip arthroplasty: a prospective, double-blind, randomized controlled study. Korean J Anesthesiol. 2025 Aug;78(4):351-360. doi: 10.4097/kja.24593. Epub 2025 Mar 13.

  PMID: 40075241 BACKGROUND

• Wu H, Li J, Li N, Zhang S, Duan L. Injectate spread following posterior hip pericapsular block: a preliminary single-case anatomical observation in a formalin-fixed cadaver. Front Pain Res (Lausanne). 2026 May 29;7:1867189. doi: 10.3389/fpain.2026.1867189. eCollection 2026.

  PMID: 42293426 BACKGROUND

• Lee KH, Wang JC, Chang CY, Teng WN, Wang HY, Lee CC, Tsai SW, Chen CF, Wu PK, Chen WM. Regional anaesthesia modalities for primary total hip arthroplasty: a systematic review and component network meta-analysis. Br J Anaesth. 2025 Aug;135(2):469-482. doi: 10.1016/j.bja.2025.04.019. Epub 2025 Jun 6.

  PMID: 40483183 BACKGROUND

• Vermeylen K, Van Aken D, Versyck B, Casaer S, Bleys R, Bracke P, Groen G. Deep posterior gluteal compartment block for regional anaesthesia of the posterior hip: a proof-of-concept pilot study. BJA Open. 2023 Feb 15;5:100127. doi: 10.1016/j.bjao.2023.100127. eCollection 2023 Mar.

  PMID: 37587997 BACKGROUND

• Cardoso FA, Fortuna-Costa A, Garcia LV. Analgesic effect of lateral femoral cutaneous nerve block added to the pericapsular nerve group (PENG) block in primary total hip arthroplasty: a randomized clinical trial. Minerva Anestesiol. 2025 Jan-Feb;91(1-2):26-35. doi: 10.23736/S0375-9393.24.18141-2. Epub 2024 Dec 4.

  PMID: 39630141 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative; Agnosia; Pain; Bites and Stings

Interventions

Dental Occlusion; Tuberculin

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Neurologic Manifestations; Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases; Poisoning; Chemically-Induced Disorders; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Dentistry; Dental Physiological Phenomena; Digestive System and Oral Physiological Phenomena; Antigens, Bacterial; Bacterial Proteins; Proteins; Amino Acids, Peptides, and Proteins; Antigens; Biological Factors

Study Officials

• Fatma Ozkan Sipahioglu, MD

  Ankara Etlik City Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Fatma Ozkan Sipahioglu, MD

CONTACT

+905531362875; ftmozkan_uzmdr@yahoo.com

Funda Atar, MD

CONTACT

+905064927432; fundaatar81@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants and the investigator responsible for postoperative outcome assessment will be blinded to group allocation. The anesthesiologist performing the nerve blocks will be aware of group allocation but will not participate in postoperative outcome assessment.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Model Details: Participants undergoing total hip arthroplasty will be randomly assigned in a 1:1 ratio to one of two parallel groups. The control group will receive PENG and LFCN blocks, while the intervention group will receive PENG and LFCN blocks combined with a posterior pericapsular deep-gluteal block. Participants will remain in their assigned group throughout the study, and postoperative outcomes will be compared between the two groups.

Study Record Dates

• First Submitted: October 10, 2026
• First Posted: October 23, 2026
• Study Start: October 20, 2026
• Primary Completion (Estimated): December 20, 2026
• Study Completion (Estimated): December 30, 2026
• Last Updated: October 23, 2026

Record last verified: 2026-10

Data Sharing

• IPD Sharing: Will not share