Supra-Iliac Anterior Quadratus Lumborum Block and Pericapsular Nerve Group (PENG) Block for Analgesia After Total Hip Arthroplasty

A Randomized Clinical Non-Inferiority Trial Comparing Supra-Iliac Anterior Quadratus Lumborum Block and Pericapsular Nerve Group (PENG) Block for Analgesia After Total Hip Arthroplasty

This study aims to compare the analgesic efficacy of supra-iliac anterior quadratus lumborum block (SA-QLB) and pericapsular nerve group (PENG) block in patients undergoing total hip arthroplasty (THA).

Study Overview

• Status: Not yet recruiting
• Conditions: Analgesia; Total Hip Arthroplasty; Pericapsular Nerve Group Block; Supra-Iliac Anterior Quadratus Lumborum Block
• Intervention / Treatment: Other: Supra-iliac anterior quadratus lumborum block; Other: Pericapsular nerve group block

Detailed Description

Total hip arthroplasty (THA) is one of the most common elective orthopedic procedures, performed to restore mobility, alleviate pain and improve quality of life in patients with degenerative hip joint disease. Its rate is projected to further increase with aging of the population worldwide.

Pericapsular nerve group (PENG) block is a fascial block targets periarticular sensory branches derived from the femoral, obturator and accessory obturator nerves innervating the anterior hip capsule.

The ultrasound-guided quadratus lumborum block (QLB) is a regional anesthetic technique with many described approaches: the lateral QL (QL1) block, the posterior QL (QL2) block, and the anterior QL (transmuscular) block.

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

Contacts and Locations

• Study Contact: Name: Mohammed S Elsharkawy, MD; Phone Number: 00201148207870; Email: mselsharkawy@med.tanta.edu.eg

Study Locations

• Egypt
  • El-Gharbia
    • Tanta, El-Gharbia, Egypt, 31527
      • Tanta University
      • Contact: Mohammed S Elsharkawy, MD; Phone Number: 00201148207870; Email: mselsharkawy@med.tanta.edu.eg

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age from 18 to 75 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) classification I-III.
• Scheduled for primary elective unilateral total hip arthroplasty (THA) under spinal anesthesia.

Exclusion Criteria:

• Known allergies to the drugs used.
• Infection at the injection site.
• Bleeding disorders.
• Recognized neuromuscular disorders.
• Opioid addiction or dependence.
• Contraindications to regional anesthesia or peripheral nerve blockade.
• Body mass index (BMI) > 40 kg/m².
• Associated decompensated cardiac, hepatic, respiratory, or renal diseases.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group SA- QLB; Patients will receive a supra-iliac anterior quadratus lumborum block (SA-QLB) using 20mL of bupivacaine 0.25%.	Other: Supra-iliac anterior quadratus lumborum block; Patients will receive a supra-iliac anterior quadratus lumborum block (SA-QLB) using 20mL of bupivacaine 0.25%.
Experimental: Group PENG; Patients will receive an ultrasound-guided pericapsular nerve group (PENG) block using 20mL of bupivacaine 0.25%.	Other: Pericapsular nerve group block; Patients will receive an ultrasound-guided pericapsular nerve group (PENG) block using 20mL of bupivacaine 0.25%.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Degree of pain	Each patient will be instructed about postoperative pain assessment with visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable")	12 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of adverse events	Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication will be recorded.	24 hours postoperatively
Total morphine consumption	Rescue analgesia of morphine will be given as 3 mg bolus if the VAS > 3 to be repeated after 30 min if pain persists until the visual analog scale (VAS) < 4. VAS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 12, 24, and 48 h postoperatively.	48 hours postoperatively
Time to the first rescue analgesia	Time to the first request for the rescue analgesia will be recorded from the end of block to first dose of morphine administrated.	48 hours postoperatively
Time to ambulation	Time to ambulation will be recorded from the end of surgery to the first successful mobilization of the patient, defined as the ability to stand and walk at least 3-5 steps with or without assistance.	Till the first successful mobilization (Up to 4 hours)
Length of hospital stay	Length of hospital stay will be recorded from admission till the discharge from hospital.	Till discharge from the hospital (Up to 2 weeks)

Collaborators and Investigators

• Sponsor: Tanta University

Study record dates

Study Major Dates

• Study Start (Estimated): May 25, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: May 19, 2026
• First Submitted That Met QC Criteria: May 19, 2026
• First Posted (Actual): May 26, 2026

Study Record Updates

• Last Update Posted (Actual): May 26, 2026
• Last Update Submitted That Met QC Criteria: May 19, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Agnosia
• Other Study ID Numbers: 36265PR1/4/26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

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