Posterior Pericapsular Deep Gluteal Block Combined With Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve Blocks for Hip Surgery Analgesia

Efficacy of Combining Ultrasound-guided Posterior Pericapsular Deep Gluteal Block to Both Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve Blocks for Postoperative Analgesia in Orthopedic Hip Surgeries

This study aims to investigate the efficacy of adding a Posterior Pericapsular Deep gluteal block to two other standard nerve blocks-the Pericapsular Nerve Group block and the Lateral Femoral Cutaneous Nerve block-for patients undergoing orthopedic hip surgery. While standard blocks target the front of the hip, many patients still feel pain in the back (posterior) of the joint. Researchers will compare two groups of patients to see if this triple-block combination provides better pain relief and reduces the need for rescue opioid medications in the 24 hours following surgery.

Study Overview

• Status: Not yet recruiting
• Conditions: Postoperative Pain; Hip Fractures; Hip Osteoarthritis
• Intervention / Treatment: Procedure: Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve Blocks.; Procedure: Posterior Pericapsular Deep Gluteal, Pericapsular Nerve Group, and Lateral Femoral Cutaneous Nerve Blocks.

Detailed Description

Patients undergoing elective orthopedic hip surgery will be randomly assigned to one of two groups. Both groups will receive general anesthesia followed by ultrasound-guided nerve blocks. Group 1 will receive a Pericapsular Nerve Group block and a Lateral Femoral Cutaneous Nerve block using 0.25% bupivacaine. Group 2 will receive these same two blocks plus an additional Posterior Pericapsular Deep gluteal block, also using 0.25% bupivacaine.

The primary goal is to evaluate postoperative pain using the Numerical Rating Scale at 6, 12, and 24 hours for both static and dynamic states. Secondary objectives include assessing quadriceps muscle strength using the Lovett Grading Method, measuring total rescue analgesia (nalbuphine) consumption, and monitoring for any complications or differences in length of hospital stay.

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Merna H Hilal, MSc, MB Bch; Phone Number: +201142220555; Email: Merna.hazem@med.asu.edu.eg
• Study Contact Backup: Name: Hany M El Zahaby, MD; Phone Number: +201227463000; Email: Hanyzahaby@hotmail.com

Study Locations

• Egypt
  • Abbasia
    • Cairo, Abbasia, Egypt, 11591
      • Ain Shams University
      • Contact: 01210366210
      • Contact: Merna H Hilal, MB BCh, MSc; Phone Number: +201142220555; Email: merna.hazem@med.asu.edu.eg

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age greater than or equal to 18 years.
• Both genders included.
• American Society of Anesthesiologists (ASA) physical status classification I-III.
• Undergoing elective orthopedic hip surgery.
• Provision of written informed consent.

Exclusion Criteria:

• Patient refusal of procedure or participation.
• American Society of Anesthesiologists (ASA) physical status classification IV.
• Allergy to any of the drugs used in the study.
• Local skin infection at the injection site.
• Coagulation disorder.
• History of cardiac arrhythmia, seizures, or increased intracranial tension.
• Alcohol or drug abuse, or psychiatric disease.
• History of chronic pain.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve Blocks.; Patients receive ultrasound-guided Pericapsular Nerve Group block and Lateral Femoral Cutaneous Nerve block using 10-15 ml of 0.25% bupivacaine for each block.	Procedure: Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve Blocks.; Patients receive ultrasound-guided Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve blocks with 10-15 ml of 0.25% bupivacaine for each block.
Experimental: Posterior Pericapsular Deep Gluteal, Pericapsular Nerve Group, Lateral Femoral Cutaneous Nerve Block; Patients receive ultrasound-guided Pericapsular Nerve Group block, Lateral Femoral Cutaneous Nerve block, and Posterior Pericapsular Deep gluteal block using 10-15 ml of 0.25% bupivacaine for each block.	Procedure: Posterior Pericapsular Deep Gluteal, Pericapsular Nerve Group, and Lateral Femoral Cutaneous Nerve Blocks.; Under ultrasound guidance, patients receive a Pericapsular Nerve Group block, a Lateral Femoral Cutaneous Nerve block, and a Posterior Pericapsular Deep gluteal block. For each of the three blocks, 10-15 ml of 0.25% bupivacaine is injected while observing for adequate fluid spread over the respective anatomical targets.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of Postoperative analgesic effect through Numerical Rating Scale Pain Score.	Evaluation of postoperative analgesic effect through the Numerical Rating Scale for both static and dynamic pain. Static pain is measured after the patient has rested in bed for 15 minutes. Dynamic pain is measured with the hip joint flexed to 45 degrees. The scale ranges from 0 (no pain) to 10 (worst possible pain).	6, 12, and 24 hours postoperatively.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quadriceps Femoris Muscle Strength.	Evaluation using the Lovett Grading Method, a manual muscle testing scale from 0 (no contractility) to 5 (complete range of motion against full resistance).	1 hour before patient movement.
Total Rescue Analgesia Consumption.	Total doses of intravenous nalbuphine (in milligrams) administered to the patient.	First 24 hours postoperatively.
Length of Hospital Stay.	The total number of days from the date of surgery until hospital discharge.	Approximately 24-72 hours (up to hospital discharge).
Occurrence of Postoperative Complications.	Monitoring for nausea, vomiting, dizziness, or infection/hematoma at the puncture site.	First 24 hours postoperatively.

Collaborators and Investigators

• Sponsor: Ain Shams University

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): October 1, 2027
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: April 9, 2026
• First Submitted That Met QC Criteria: April 9, 2026
• First Posted (Actual): April 15, 2026

Study Record Updates

• Last Update Posted (Actual): April 22, 2026
• Last Update Submitted That Met QC Criteria: April 18, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Pericapsular Nerve Group Block; Lateral Femoral Cutaneous Nerve Block; Multimodal Analgesia; Ultrasound-Guided Regional Anesthesia; Posterior Pericapsular Deep Gluteal Block; Orthopedic Hip Surgery
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Wounds and Injuries; Postoperative Complications; Pathologic Processes; Arthritis; Joint Diseases; Rheumatic Diseases; Leg Injuries; Fractures, Bone; Osteoarthritis; Femoral Fractures; Hip Injuries; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Hip Fractures; Osteoarthritis, Hip
• Other Study ID Numbers: FMASU MD274/2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No plan to share

Drug and device information, study documents

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