Pericapsular Nerve Group (PENG) Block Combined With Lateral Femoral Cutaneous Nerve (LFCN) Block or Wound Infiltration for Postoperative Analgesia in Anterior Approach Total Hip Arthroplasty: A Randomized Controlled Trial (Peng_lfcn/WI)

Ospedale Edoardo Bassini

Status: Not yet enrolling

Conditions: Hospital Stay, Length of Stay in Hospital From Time of Surgery Till Discharge; Hip Arthropathy; Opioid Consumption; Arthropathy of Hip; Regional Anesthesia Morbidity; Locoregional Anesthesia; Complication of Anesthesia

Treatments: Procedure: PENG plus LFCN block; Procedure: PENG plus WI

Study type: Interventional

Funder types: Other

Identifiers

NCT07284615

5967

Details and patient eligibility

About

This prospective, randomized controlled trial aims to compare two multimodal regional anesthesia strategies for postoperative analgesia in elective total hip arthroplasty (THA) performed via anterior approach. Patients will be randomized to receive either a Pericapsular Nerve Group (PENG) block combined with a Lateral Femoral Cutaneous Nerve (LFCN) block, or a PENG block combined with wound infiltration (WI).

The primary outcome is postoperative pain intensity at rest, measured by Numerical Rating Scale (NRS) at 6 hours after surgery. Secondary outcomes include dynamic pain scores at 6, 24, and 48 hours, total opioid consumption, time to first rescue analgesia, quadriceps strength, hip flexion angle, length of stay, and adverse events.

All procedures are routinely used in clinical practice and carry minimal additional risk. Safety will be continuously monitored by the Principal Investigator and the study team according to an internal Safety Monitoring Plan.

Enrollment: 102 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age > 18 years
• Elective total hip arthroplasty
• Spinal (subarachnoid) anesthesia
• Written informed consent provided by the patient or by the legal guardian, if appointed

Exclusion criteria

• INR > 1.5
• aPTT > 1.5
• Platelet count < 75,000/mm³
• Signs suggestive of infection at the puncture site
• Absence of informed consent to the procedure
• Documented or suspected allergy to local anesthetics

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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102 participants in 2 patient groups

PENG - LFCN Block

Experimental group

Description:

group in which PENG and LFCN Block was performed. After performing neuraxial anesthesia, the PENG associated with LFCN block will be performed. Under ultrasound guidance, 20ml and 10ml of Ropivacaine 0.5% will be administered respectively

Treatment:

Procedure: PENG plus LFCN block

PENG-WI

Active Comparator group

Description:

the group in which PENG and WI (wound infiltration) are performed, after neuraxial anesthesia, a PENG block will be administered under ultrasound guidance using 20 mL of 0.5% ropivacaine. At the end of the surgery, a wound infiltration will be performed with 10 mL of 0.5% ropivacaine.

Treatment:

Procedure: PENG plus WI