Pericapsular Nerve Group With Lateral Femoral Cutaneous Nerve Block vs Suprainguinal Fascia Iliaca Block for Analgesia in Total Hip Arthroplasty: A Prospective Comparative Study

Comparison of Postoperative Analgesic Efficacy of Suprainguinal Fascia Iliaca Block (SFIB) and Pericapsular Nerve Group (PENG) Block With Lateral Femoral Cutaneous Nerve (LFCN) Block in Patients Undergoing Total Hip Arthroplasty

Prospective observational cohort comparing analgesic efficacy of suprainguinal fascia iliaca block (SFIB) vs pericapsular nerve group block combined with lateral femoral cutaneous nerve block (PENG+LFCN) in primary total hip arthroplasty under general anesthesia (n=48). Outcomes include VAS pain at rest and with movement at 3, 12, 24, 48 h; morphine use (0-3, 3-12, 12-24, 24-48 h; total 0-48 h); quadriceps strength at 6 and 24 h; physiotherapy participation at 24 and 48 h; and adverse events within 48 h.

Study Overview

• Status: Completed
• Conditions: Coxarthrosis; Primary

Detailed Description

Adults undergoing primary posterolateral THA under general anesthesia were included if they received either SFIB or PENG+LFCN. Pain (VAS at rest and with 45° passive flexion) was recorded at 3, 12, 24, and 48 h. Morphine via PCA was recorded for 0-3, 3-12, 12-24, and 24-48 h, with a 0-48 h total. Quadriceps strength (0-2 scale) was assessed at 6 and 24 h; physiotherapy participation at 24 and 48 h; opioid- or block-related adverse events through 48 h.

• Study Type: Observational
• Enrollment (Actual): 48

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye), 06230
    • Hacettepe University Hospitals

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

48 patients of American Society of Anesthesiologists physical status I-II between the age of 18 to 90 years who were scheduled to undergo primary Total hip arthroplasty with a diagnosis of coxarthrosis

Description

Inclusion Criteria:

• Patients who are scheduled to undergo primary total hip arthroplasty with a diagnosis of coxarthosis

Exclusion Criteria:

• Patients who have a history of neuropathy, patients with renal and hepatic insufficiency, patients with known coagulopathy, patients with a history of allergy to local anesthetics, patients with a history of inguinal surgery on the same side and patients with impaired mental status

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
SFIB; Patients undergoing THA who received ultrasound-guided SFIB with 0.25% bupivacaine 40 mL under the fascia iliaca with cranial spread.
PENG; Patients undergoing THA who received ultrasound-guided PENG (0.5% bupivacaine 15 mL) at the iliopubic eminence plus LFCN block (0.5% bupivacaine 5 mL) distal to the inguinal ligament.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analogue Scale scores	Postoperative Visual Analogue Scale scores ( Minimum of 0 and maximum of 10 with higher scores indicative of more severe pain) will be measured at rest and 45 degrees passive flexion at 3, 12, 24 and 48th hours postoperatively	In the 48 hours following surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quadriceps weakness	Quadriceps weakness will be assessed at 6 and 24th hours after surgery. The patient will be asked to extend the knee with the hip flexed at 45 degrees. Quadriceps strength will be graded according to the following: Grade 0: No extension, Grade 1: Extension against gravity but not against resistance, Grade 2: Extension against gravity and resistance.	In the 48 hours following surgery
Ability to perform physiotherapy	Ability to perform physiotherapy and whether the inability to perform physiotherapy was due to pain or motor weakness will be recorded by the physiotherapist at 24 and 48 hours after surgery	In the 48 hours following surgery
Opioid consumption	Opioid consumption during 0-3,12-24, 24-48 hours and cumulative opioid consumption at 48h will be recorded following surgery	In the 48 hours following surgery

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adverse effects	Any occurring adverse effects due to opioid use or nerve block will be recorded should they occur.	In the 48 hours following surgery

Collaborators and Investigators

• Sponsor: Hacettepe University

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2024
• Primary Completion (Actual): April 15, 2024
• Study Completion (Actual): April 15, 2024

Study Registration Dates

• First Submitted: February 19, 2025
• First Submitted That Met QC Criteria: February 19, 2025
• First Posted (Actual): February 25, 2025

Study Record Updates

• Last Update Posted (Estimated): August 26, 2025
• Last Update Submitted That Met QC Criteria: August 25, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Postoperative analgesia; PENG block; Suprainguinal fascia iliaca block; Lateral femoral cutaneous nerve block
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Osteoarthritis, Hip
• Other Study ID Numbers: KA-22088

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No