Perioperative Analgesic Effects of PENG Versus PENG Plus LFCN Block in Hip Surgeries

January 9, 2026 updated by: Muzaffer GENCER, Başakşehir Çam & Sakura City Hospital

Comparison of Postoperative Analgesic Efficacy of Preoperative Pericapsular Nerve Group (PENG) Block With PENG Block and Lateral Femoral Cutaneous Nerve Block in Lateral Incision Hip Surgery

This study is designed to find the best way to control pain after hip surgery performed through a side (lateral) incision. Two different types of nerve blocks used before the operation will be compared.

In one group, patients will receive a Pericapsular Nerve Group (PENG) block, which numbs the main nerves that carry pain signals from the hip joint. In the other group, patients will receive a PENG block together with a Lateral Femoral Cutaneous Nerve (LFCN) block, which adds extra pain relief for the skin and outer part of the thigh.

A total of 72 patients between 18 and 80 years old will take part in this study. All operations will be done under spinal anesthesia. Pain levels will be measured several times during the first 24 hours after surgery using a simple 0-10 pain scale. Patients will receive pain medicine through a pump that allows them to press a button when they feel pain. The total amount of medicine used will be recorded.

The researchers will also monitor when patients first need pain medicine, when they can start walking, how satisfied they are with pain control, and if they experience side effects such as nausea or dizziness.

By comparing the two methods, the study aims to see whether adding the LFCN block to the PENG block provides better pain control, lower drug use, faster recovery, and higher patient comfort after hip surgery.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Postoperative pain following hip surgery remains a significant clinical challenge, particularly in procedures performed through a lateral incision, where both deep articular and superficial cutaneous pain components contribute to patient discomfort. Effective regional anesthesia techniques are essential to optimize postoperative analgesia, facilitate early mobilization, and reduce opioid-related adverse effects.

The Pericapsular Nerve Group (PENG) block has been introduced as a motor-sparing regional anesthesia technique targeting the articular branches of the femoral, obturator, and accessory obturator nerves, providing effective analgesia for hip joint-related pain. However, due to its limited coverage of cutaneous innervation, patients undergoing lateral incision hip surgery may continue to experience residual superficial pain.

The Lateral Femoral Cutaneous Nerve (LFCN) block selectively targets the sensory innervation of the anterolateral thigh and may complement the PENG block by addressing the cutaneous component of postoperative pain. The combined use of PENG and LFCN blocks has the potential to provide more comprehensive analgesia without compromising motor function.

This study is designed to evaluate whether the addition of an LFCN block to a standard PENG block enhances postoperative pain control and recovery outcomes in patients undergoing hip surgery via a lateral approach. By comparing these two regional anesthesia strategies, the study aims to contribute evidence-based guidance for optimizing multimodal analgesia protocols in hip surgery.

Study Type

Interventional

Enrollment (Estimated)

72

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • BASAKSEHİR
      • Istanbul, BASAKSEHİR, Turkey (Türkiye), 34490
        • Başakşehir Çam and Sakura City Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients aged between 18 and 80 years
  • Patients scheduled for elective or trauma-related hip surgery performed through a lateral incision under spinal anesthesia
  • Patients receiving a preoperative ultrasound-guided Pericapsular Nerve Group (PENG) block or a PENG block combined with a Lateral Femoral Cutaneous Nerve (LFCN) block
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Patients with full orientation and the ability to cooperate
  • Ability to understand the study procedures and provide written informed consent

Exclusion Criteria:

  • Contraindications to regional anesthesia, including coagulopathy or local infection at the injection site
  • Presence of neuropathic disorders or conditions that may affect pain perception, including chronic analgesic use
  • Requirement for conversion to general anesthesia
  • Postoperative admission to the intensive care unit
  • Known allergy or hypersensitivity to opioids or local anesthetics
  • American Society of Anesthesiologists (ASA) physical status IV-V

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: PENG BLOCK GROUP
An ultrasound-guided Pericapsular Nerve Group (PENG) block will be performed preoperatively using standard local anesthetic techniques to provide postoperative analgesia in patients undergoing lateral incision hip surgery.
Procedure: Pericapsular nerve group (PENG) block
An ultrasound-guided Pericapsular Nerve Group (PENG) block will be performed preoperatively using standard local anesthetic techniques to provide postoperative analgesia in patients undergoing lateral incision hip surgery.
Experimental: PENG + LFCN BLOCK GROUP
Patients in this group will receive a preoperative ultrasound-guided Pericapsular Nerve Group (PENG) block combined with a Lateral Femoral Cutaneous Nerve (LFCN) block for postoperative analgesia prior to lateral incision hip surgery under spinal anesthesia.
Procedure: Pericapsular nerve group (PENG) block
An ultrasound-guided Pericapsular Nerve Group (PENG) block will be performed preoperatively using standard local anesthetic techniques to provide postoperative analgesia in patients undergoing lateral incision hip surgery.
Procedure: Lateral Femoral Cutaneous Nerve (LFCN) Block
An ultrasound-guided Lateral Femoral Cutaneous Nerve (LFCN) block will be performed preoperatively as an adjunct to the PENG block to enhance postoperative analgesia in patients undergoing lateral incision hip surgery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Pain Intensity (NRS Score)
Time Frame: 2, 6, 12, and 24 hours postoperatively
Postoperative pain intensity will be assessed using the Numeric Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain), both at rest and during movement.
2, 6, 12, and 24 hours postoperatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total Postoperative Opioid Consumption
Time Frame: First 24 hours postoperatively
Total opioid consumption during the first 24 hours postoperatively will be recorded using a patient-controlled analgesia (PCA) device and converted to morphine equivalent dose (mg).
First 24 hours postoperatively
Time to First Mobilization
Time Frame: Within the first 24 hours postoperatively
Time to first mobilization after surgery will be recorded in hours.
Within the first 24 hours postoperatively
Patient Satisfaction Score
Time Frame: Within the first 24 hours postoperatively
Patient satisfaction with postoperative pain management will be assessed using a 5-point Likert Satisfaction Scale, ranging from 1 (very dissatisfied) to 5 (very satisfied), where higher scores indicate greater patient satisfaction.
Within the first 24 hours postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Başakşehir Çam & Sakura City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2025

Primary Completion (Estimated)

February 1, 2026

Study Completion (Estimated)

July 1, 2026

Study Registration Dates

First Submitted

December 27, 2025

First Submitted That Met QC Criteria

December 27, 2025

First Posted (Estimated)

January 9, 2026

Study Record Updates

Last Update Posted (Estimated)

January 12, 2026

Last Update Submitted That Met QC Criteria

January 9, 2026

Last Verified

July 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BSH-ANES-MG-01

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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