Effects of Pericapsular Nerve Group Block on Postoperative Recovery for Total Hip Arthroplasty

The hypothesis of this study is that patients who undergo PENG block in before Total Hip Artroplasthy (THA) surgery with spinal anesthesia will have reduced postoperative pain scores, less need for opioid analgesics and earlier mobilisation.

Study Overview

• Status: Recruiting
• Conditions: Analgesia; Postoperative Pain, Acute
• Intervention / Treatment: Procedure: Pericapsular Nerve Group (PENG) Block

Detailed Description

This prospective randomised controlled study included a total of 60 patients aged 40-85 years who underwent THA surgery under spinal anaesthesia. Patients were divided into two groups as PENG block (n:30) and non-PENG block (n:30). PENG block was placed in the fascial plane between the pseudotendon and pubic ramus with USG in-plane technique, 20 ml of 0.5% bupivacaine was administered and surgery was initiated. The primary outcome of the study was to investigate the effect of preoperative PENG block application on postoperative pain, opioid requirement, mobilisation time, hip joint patency and length of hospital stay in patients undergoing THA surgery. The secondary outcome was to investigate the effect of PENG block on perioperative haemodynamics and postoperative side effects.

For multimodal analgesia, 10 ml 0.5% bupivacaine + 10 ml 2% lidocaine is infiltrated into the surgical wound incision line by the surgical team at the end of surgery. After tramadol 50 mg loading with PCA device, a basal rate of 5-10 mg/hour (20 mg bolus dose + 30 minutes lock time) is given with paracetamol 10 mg/kg iv (8 hours interval).

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: zeliha tuncel, ass prof; Phone Number: +905053577483; Email: zelihalara@yahoo.com
• Study Contact Backup: Name: hale arkan tuna, specialist dr; Phone Number: +905303705619; Email: halearkan@yahoo.com.tr

Study Locations

• Turkey (Türkiye)
  • Umraniye
    • Istanbul, Umraniye, Turkey (Türkiye), 34734
      • Recruiting
      • UmraniyeERH
      • Contact: zeliha tuncel, ass prof; Phone Number: +905053577483; Email: zelihalara@yahoo.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• THA performed by posterior approach
• 40-85 age range
• ASA 1-3

Exclusion Criteria:

Under 40 years of age, over 85 years of age,

• ASA 4 and above,
• Cognitive impairment (Alzheimer's disease, dementia, delirium etc.),
• Hip fracture,
• Application site infection,
• Allergy to local anaesthetic agents,
• Patients are non-consenting patients.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: PENG group; PENG block was placed in the fascial plane between the pseudotendon and pubic ramus with USG in-plane technique, 20 ml of 0.5% bupivacaine was administered after spinal anaesthesia.	Procedure: Pericapsular Nerve Group (PENG) Block; With ultrasonography-guided PENG block, the femoral, obturator and accessory obturator nerve branches that provide sensory innervation of the anterior surface of the hip joint capsule are blocked .
Placebo Comparator: non-PENG group; group non-PENG, surgery was started without PENG block after spinal anaesthesia.	Procedure: Pericapsular Nerve Group (PENG) Block; With ultrasonography-guided PENG block, the femoral, obturator and accessory obturator nerve branches that provide sensory innervation of the anterior surface of the hip joint capsule are blocked .

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
postoperative pain score	VAS pain score	recovery room 30 min, 12., 24. and 48. hours in the postoperative period
mobilisation time	walking 5 steps with walker	24 -48 hours
hip joint patency	Measurement of joint movement angle with goniometer (angle)	24. hours
total opioid consumption	Tramadol total usage (mg)	48 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PENG block side effects	motor block, nausea, vomiting, anaphylaxis, nerve damage	The first 48 hours after performing the PENG block
Perioperative haemodynamic data	heart rate, mean arterial pressure	T1: 30 minutes (min) after spinal anesthesia, T2: at the end of the surgical procedure, T3: at 30 minutes after recovery
length of hospital stay	hospitalization and discharge time for surgery	day

Collaborators and Investigators

• Sponsor: Umraniye Education and Research Hospital
• Investigators: Study Director: zeliha tuncel, Ümraniye Training and Education hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2023
• Primary Completion (Actual): October 10, 2024
• Study Completion (Estimated): December 30, 2025

Study Registration Dates

• First Submitted: November 30, 2023
• First Submitted That Met QC Criteria: December 13, 2023
• First Posted (Actual): December 27, 2023

Study Record Updates

• Last Update Posted (Actual): November 19, 2025
• Last Update Submitted That Met QC Criteria: November 16, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: total hip arthroplasty; spinal anesthesia; Multimodal analgesia; pericapsular nerve group block
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Nervous System Diseases; Postoperative Complications; Pathologic Processes; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Agnosia; Digestive System and Oral Physiological Phenomena; Dentistry; Dental Physiological Phenomena; Dental Occlusion
• Other Study ID Numbers: UERH-AR-ZT-02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No