Effect of PENG Block on Postoperative Tramadol Consumption in Partial Hip Prosthesis Surgery (PENG-PKP)

Comparison of Postoperative Tramadol Consumption, Clinical Effects, and Side Effects in Patients With and Without PENG (Pericapsular Nerve Group) Block in Partial Hip Prosthesis Surgery

This study aims to evaluate the effect of ultrasound-guided pericapsular nerve group (PENG) block on postoperative tramadol consumption, pain scores, and clinical outcomes in patients undergoing partial hip prosthesis surgery. Patients aged 18-75 years scheduled for surgery under general anesthesia were divided into two groups: those receiving PENG block and those not receiving the block. Postoperative tramadol consumption within the first 24 hours, visual analog scale (VAS) and numeric rating scale (NRS) scores, hemodynamic parameters, additional analgesic requirements, and recovery characteristics were recorded and compared between groups. The findings of this study are expected to contribute to optimizing multimodal analgesia strategies in hip surgery.

Study Overview

• Status: Completed
• Conditions: Postoperative Pain; Hip Fracture
• Intervention / Treatment: Procedure: PENG Block; Procedure: General Anesthesia

Detailed Description

Postoperative pain management in hip surgery remains a significant clinical challenge, particularly in elderly patients. Effective analgesia is essential to reduce opioid consumption, improve patient comfort, and enhance recovery. The pericapsular nerve group (PENG) block is a relatively new regional anesthesia technique that targets the articular branches of the femoral, obturator, and accessory obturator nerves, providing analgesia to the anterior hip capsule.

This prospective study was conducted to compare the clinical effects of PENG block in patients undergoing partial hip prosthesis surgery under general anesthesia. A total of 48 patients aged between 18 and 75 years were included and divided into two groups: the PENG group (Group P), which received ultrasound-guided PENG block with 20 mL of 0.5% bupivacaine after induction of general anesthesia, and the control group (Group K), which received general anesthesia alone.

Demographic data, intraoperative anesthetic requirements, and postoperative parameters were recorded. The primary outcome measure was total tramadol consumption within the first 24 hours after surgery. Secondary outcomes included postoperative pain scores (VAS and NRS), hemodynamic parameters (mean arterial pressure and heart rate), remifentanil consumption, need for additional analgesia, bispectral index (BIS) values, patient comfort score, modified Aldrete recovery score, Riker agitation-sedation scale, and incidence of complications such as nausea, vomiting, hypotension, hypertension, and arrhythmia.

The results of this study are intended to evaluate the effectiveness of PENG block as a component of multimodal analgesia and to determine its impact on opioid consumption and postoperative recovery in patients undergoing hip surgery.

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Gaziantep, Turkey (Türkiye), 27310
    • Gaziantep University Faculty Of Medicine

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients aged between 18 and 75 years
• Patients scheduled for partial hip prosthesis surgery
• Patients classified as ASA physical status I-III
• Patients who provided written informed consent

Exclusion Criteria:

• Known allergy to local anesthetics
• Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia
• Infection at the injection site
• Severe systemic disease (ASA IV or higher)
• Cognitive impairment preventing reliable pain assessment
• Refusal to participate in the study

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Group	Procedure: General Anesthesia; Standard general anesthesia administered without regional nerve block.
Experimental: PENG Block Group; Patients receiving ultrasound-guided PENG block after induction of general anesthesia.	Procedure: PENG Block; Ultrasound-guided pericapsular nerve group block performed with 20 mL of 0.5% bupivacaine after induction of general anesthesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total Tramadol Consumption Within 24 Hours After Surgery	Total amount of tramadol (mg) consumed by patients during the first 24 hours after surgery.	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intraoperative Remifentanil Consumption	Total amount of remifentanil used during surgery.	Intraoperative period
Additional Analgesic Requirement	Requirement for additional analgesic medication in the postoperative period.	24 hours postoperatively
Postoperative Complications	Incidence of complications including nausea, vomiting, hypotension, hypertension, arrhythmia, and pruritus.	24 hours postoperatively
Postoperative VAS Pain Scores	Visual Analog Scale (VAS) pain scores ranging from 0 to 10, where 0 indicates no pain and 10 indicates worst imaginable pain, measured at predefined postoperative time points.	0, 10, 30, 60 minutes and 2, 4, 6, 12, 24 hours postoperatively
Postoperative NRS Pain Scores	Numeric Rating Scale (NRS) pain scores ranging from 0 to 10, where 0 indicates no pain and 10 indicates worst possible pain, measured at predefined postoperative time points.	0, 10, 30, 60 minutes and 2, 4, 6, 12, 24 hours postoperatively

Collaborators and Investigators

• Sponsor: University of Gaziantep

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2022
• Primary Completion (Actual): October 1, 2022
• Study Completion (Actual): December 1, 2022

Study Registration Dates

• First Submitted: April 9, 2026
• First Submitted That Met QC Criteria: April 9, 2026
• First Posted (Actual): April 16, 2026

Study Record Updates

• Last Update Posted (Actual): April 22, 2026
• Last Update Submitted That Met QC Criteria: April 17, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Postoperative pain; Regional anesthesia; Hip surgery; peng block; Pericapsular nerve group block; Tramadol consumption
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Wounds and Injuries; Postoperative Complications; Pathologic Processes; Leg Injuries; Fractures, Bone; Femoral Fractures; Hip Injuries; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Hip Fractures; Anesthesia and Analgesia; Anesthesia; Anesthesia, General
• Other Study ID Numbers: GAUN-2022-248

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared due to institutional policies and patient confidentiality considerations.

Drug and device information, study documents

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