PENG With LFCB vs. ESP Blocks for Pediatric Hip Surgery

Poznan University of Medical Sciences (PUMS)

Status and phase: Enrolling; Phase 4

Conditions: Hip Arthropathy; Hip Disease; Hip Dysplasia

Treatments: Drug: Ropivacaine 0.2% for LFCB; Drug: Ropivacaine 0.2% for L-ESPB; Drug: Ropivacaine 0.2% for S-ESPB; Drug: Ropivacaine 0.2% for PENG Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07023094

6/2025

Details and patient eligibility

About

This randomized controlled trial (RCT) compares the analgesic effectiveness of two regional anesthesia techniques-Pericapsular Nerve Group (PENG) block combined with Lateral Femoral Cutaneous Nerve Block (LFCB) versus Lumbar and Sacral Erector Spinae Plane Blocks (L-ESPB and S-ESPB)-in pediatric patients undergoing hip surgery.

Full description

Orthopedic hip procedures in pediatric patients, including osteotomies, arthroscopic interventions, and reconstructive surgeries, often result in significant postoperative pain. Effective analgesia is critical for reducing surgical stress, accelerating rehabilitation, and minimizing opioid use and associated side effects. Regional anesthesia techniques have gained attention for their opioid-sparing effects and enhanced recovery profiles.

This randomized controlled trial aims to compare the analgesic effectiveness of two regional anesthetic approaches:

• The pericapsular nerve group (PENG) block is combined with the lateral fetal cutaneous nerve block (LFCB), targeting hip joint innervation directly and providing comprehensive sensory coverage.

Lumbar and sacral erector spinae plane blocks (L-ESPB and S-ESPB) employ fascial plane techniques to deliver analgesia by diffusing local anesthetic around nerves innervating the hip region.

This trial aims to establish the optimal regional anesthesia technique and determine the clinical benefits of using dexamethasone and dexmedetomidine as adjuvants. The results will guide clinicians toward evidence-based analgesic protocols in pediatric orthopedic hip surgery, potentially reducing opioid-related complications and improving patient recovery outcomes.

Enrollment: 60 estimated patients

Sex: All

Ages: 2 to 16 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Pediatric patients aged between 2 and 16 years.
• Scheduled for elective orthopedic hip surgery, including: Osteotomies and Hip reconstruction surgeries
• ASA (American Society of Anesthesiologists) physical status classification: I-III.
• Written informed consent obtained from the patient's legal guardian(s).

Exclusion criteria

• Known allergy or hypersensitivity to any of the study medications
• Presence of infection or inflammation at the intended injection site(s) of regional anesthesia.
• Coagulopathy or bleeding disorders (including patients on anticoagulant therapy) that contraindicate nerve blocks.
• Neurological disorders or peripheral neuropathies that could influence sensory or motor assessment of the lower limbs.
• Cognitive impairment or behavioral disorders significantly affecting pain assessment accuracy or cooperation.
• History of chronic opioid use or known substance abuse.
• Severe systemic disease or condition compromising patient safety or interfering with study protocol adherence.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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60 participants in 2 patient groups

PENG + LFCB

Active Comparator group

Description:

U-S guided PENG block - 0.4ml/kg 0.2% ropivacaine + U-S guided LFCB - 0.1ml/kg 0.2% ropivacaine

Treatment:

Drug: Ropivacaine 0.2% for PENG Block

Drug: Ropivacaine 0.2% for LFCB

L-ESPB + S-ESPB

Active Comparator group

Description:

U-S guided L-ESPB - 0.25ml/kg 0.2% ropivacaine + U-S guided S-ESPB - 0.25ml/kg 0.2% ropivacaine

Treatment:

Drug: Ropivacaine 0.2% for S-ESPB

Drug: Ropivacaine 0.2% for L-ESPB