Postoperative Analgesic Efficacy of PENG and QLB Blocks in Hip Surgeries (PENG vs QLB)

Gaziosmanpasa Research and Education Hospital

Status: Completed

Conditions: Hip Surgery; Postoperative Analgesia

Treatments: Procedure: anterior quadratus lumborum block; Procedure: PENG block with 0.25% bupivacaine.

Study type: Interventional

Funder types: Other

Identifiers

NCT06653894

GaziosmanpasaTREH-PENG

Details and patient eligibility

About

This prospective, randomized, single-blinded study compares the postoperative analgesic efficacy of the Pericapsular Nerve Group (PENG) block and Quadratus Lumborum Block (QLB) in hip surgeries under spinal anesthesia. the study focuses on time to first rescue analgesia and total analgesic consumption within the first 48 hours postoperatively in patients over 40 years undergoing elective hip surgery. Ninety patients will be randomized into two groups (PENG or QLB) using a sealed envelope method. The study will assess pain scores, opioid consumption, and side effects, hypothesizing that both blocks provide effective analgesia but seek to identify which offers superior efficacy. Statistical analysis will be performed with SPSS, aiming to contribute valuable insights into analgesic techniques for hip surgeries.

Full description

This is a prospective, randomized single-blinded study comparing the postoperative analgesic efficacy of Pericapsular Nerve Group (PENG) block and Quadratus Lumborum Block (QLB) in hip surgeries performed under spinal anesthesia. The study aims to evaluate key outcomes such as the time to first rescue analgesia and total analgesic consumption within the first 48 hours postoperatively. The primary population includes patients over 40 years undergoing elective hip surgery with specific inclusion and exclusion criteria. ninety patients will be divided into two groups, receiving either QLB or PENG block, using a sealed envelope randomization method.

PENG block targets specific nerves to provide analgesia without motor block, preserving motor function. QLB involves injecting a local anesthetic into the fascia near the quadratus lumborum muscle to block thoracoabdominal nerves and provide broad analgesia. Data on pain scores (NRS), opioid consumption, and side effects will be collected at different time points.

The study hypothesizes that both blocks can provide effective postoperative analgesia, with potential benefits such as reduced opioid consumption , but aims to determine which block is superior in efficacy.

The primary aim of this study was to compare the effect of an anterior QLB and PENG block on total opioid analgesic consumption within the first 48 hours postoperatively. The secondary aims were to compare the resting and dynamic NRS scores at 2, 12, 24 and 48 hours postoperatively, the time to first rescue analgesia, and side effects such as nausea, vomiting and quadriceps weakness.

Statistical analysis will be conducted using SPSS, and findings will contribute to the literature on analgesia techniques for hip surgeries.

Enrollment: 73 patients

Sex: All

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• "Patients aged over 40 years who are scheduled to undergo hip surgery under spinal anesthesia and classified as ASA 1-3 will be included in the study."

Exclusion criteria

• Patients who refuse the procedure.
• Patients who will receive general anesthesia or peripheral nerve blocks such as a combination of femoral and sciatic nerve blocks.
• A history of allergy to local anesthetic agents.
• Patients with a diagnosis of neurocognitive disorders such as dementia or Alzheimer's disease under active neurological follow-up.
• Patients with multiple trauma.
• Patients with severe hearing or vision impairments.
• Patients with a local infection at the site of the block application.
• Patients with a Body Mass Index (BMI) > 35.
• Patients with a history of severe neurological, cardiovascular, renal, or hepatic disease will be excluded from the study.
• Patients who, during the postoperative period, required intensive care unit (ICU) admission for more than one day due to hemodynamic monitoring or sedation, as well as those who developed complications during postoperative follow-up-such as re-operation, postoperative hemorrhage, or the need for advanced cardiopulmonary support-were excluded from the study.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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73 participants in 2 patient groups

QLB Group

Active Comparator group

Description:

In the QLB (Quadratus Lumborum Block) group, patients will be placed in the lateral decubitus position, and the block will be performed using ultrasound guidance

Treatment:

Procedure: anterior quadratus lumborum block

PENG Block Group

Active Comparator group

Description:

In the PENG (Pericapsular Nerve Group) block group, patients will be positioned supine, and the block will be performed under ultrasound guidance.

Treatment:

Procedure: PENG block with 0.25% bupivacaine.