Comparison of Meta-PENG and Suprainguinal Fascia Iliaca Plane Block in Hip Fractures (META-SIFI)

May 23, 2026 updated by: Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital

Comparison of the Effects of Ultrasound-Guided Meta-PENG Block and Suprainguinal Fascia Iliaca Plane Block in Patients Undergoing Hip Fracture Surgery Under Spinal Anesthesia

This prospective observational single-center study will compare the effects of ultrasound-guided meta-PENG block and suprainguinal fascia iliaca plane block in patients undergoing hip fracture surgery under spinal anesthesia.

Hip fracture surgery can cause significant pain before, during, and after the operation. Regional anesthesia techniques may help reduce pain, improve positioning for spinal anesthesia, decrease the need for additional analgesics, and support earlier mobilization.

Patients included in the study will be adults scheduled for hip fracture surgery under spinal anesthesia. According to routine clinical practice and the anesthesiologist's decision, patients will receive either ultrasound-guided meta-PENG block or ultrasound-guided suprainguinal fascia iliaca plane block. The study will not assign patients to a treatment group by randomization.

The main outcome will be pain during positioning for spinal anesthesia, measured using the Numeric Rating Scale. Additional outcomes will include postoperative pain at rest and during activity, additional analgesic consumption, patient satisfaction, mobilization time, and length of hospital stay.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Hip fractures are common, especially in older adults, and are associated with significant perioperative pain, delayed mobilization, increased analgesic requirements, and prolonged hospitalization. Effective perioperative pain control is important in this patient population because inadequate analgesia may impair positioning for spinal anesthesia, increase postoperative discomfort, and delay recovery.

Regional anesthesia techniques are frequently used as part of multimodal analgesia in patients undergoing hip fracture surgery. The suprainguinal fascia iliaca plane block is a regional block technique that may provide analgesia by affecting nerves related to the lumbar plexus, including the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve. The pericapsular nerve group block and modified techniques, including meta-PENG block, aim to provide analgesia by targeting articular branches involved in hip joint innervation.

This study is designed as a prospective observational single-center study. Adult patients with ASA physical status I-III who are scheduled to undergo hip fracture surgery under spinal anesthesia will be evaluated for eligibility. Patients who provide written informed consent, or whose legal representative provides consent when applicable, will be included.

The regional block technique will be determined according to routine clinical practice and the responsible anesthesiologist's preference. Patients will not be randomized by the study protocol. Patients will be observed in two groups: those receiving ultrasound-guided meta-PENG block and those receiving ultrasound-guided suprainguinal fascia iliaca plane block.

The primary outcome of the study is pain during positioning for spinal anesthesia. Pain will be assessed using the Numeric Rating Scale, where 0 indicates no pain and 10 indicates the worst imaginable pain.

Secondary outcomes will include postoperative Numeric Rating Scale scores at rest and during activity, including back raising and hip flexion; additional analgesic consumption; patient satisfaction assessed using the OR-15 questionnaire; time to mobilization; and length of hospital stay.

Intraoperative data, spinal anesthesia medication dose, regional block and anesthesia methods, postoperative pain scores, additional analgesic requirements, mobilization time, patient satisfaction, and hospitalization duration will be recorded from the hospital information system and anesthesia records.

The study will be conducted at Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital. The study has been reviewed and approved by the institutional scientific research ethics committee.

Study Type

Observational

Enrollment (Estimated)

80

Contacts and Locations

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

Study Contact

Study Contact Backup

  • Name: Şule Altuncu, MD
  • Phone Number: +90 539 910 1999

Study Locations

  • Turkey (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Turkey (Türkiye), 34000
        • Recruiting
        • Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital
        • Contact:

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

Sampling Method

Non-Probability Sample

Study Population

Adult patients scheduled to undergo hip fracture surgery under spinal anesthesia at Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital will be included. Eligible patients will be ASA physical status I-III and will receive either ultrasound-guided meta-PENG block or ultrasound-guided suprainguinal fascia iliaca plane block as part of routine perioperative analgesia management.

Description

Inclusion Criteria:

  • Age greater than 18 years
  • ASA physical status I-III
  • Scheduled to undergo hip fracture surgery under spinal anesthesia
  • Written informed consent obtained from the patient or the patient's legal representative

Exclusion Criteria:

  • Refusal to participate in the study
  • ASA physical status IV-V
  • Presence of central or autonomic nervous system disease
  • Known allergy to the drugs used in the study

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Meta-PENG Block Group
Patients undergoing hip fracture surgery under spinal anesthesia who receive ultrasound-guided meta-PENG block as part of routine perioperative analgesia management.
Procedure: Ultrasound-Guided Meta-PENG Block
Ultrasound-guided meta-PENG block performed as part of routine perioperative regional analgesia management in patients undergoing hip fracture surgery under spinal anesthesia.
Suprainguinal Fascia Iliaca Plane Block Group
Patients undergoing hip fracture surgery under spinal anesthesia who receive ultrasound-guided suprainguinal fascia iliaca plane block as part of routine perioperative analgesia management.
Procedure: Ultrasound-Guided Suprainguinal Fascia Iliaca Plane Block
Ultrasound-guided suprainguinal fascia iliaca plane block performed as part of routine perioperative regional analgesia management in patients undergoing hip fracture surgery under spinal anesthesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain During Positioning for Spinal Anesthesia
Time Frame: During the positioning for spinal anesthesia, immediately before spinal needle insertion(Periprocedural)
Pain intensity during positioning for spinal anesthesia will be assessed using the Numeric Rating Scale. The Numeric Rating Scale ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.
During the positioning for spinal anesthesia, immediately before spinal needle insertion(Periprocedural)

Collaborators and Investigators

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

Sponsor

Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital

Investigators

  • Principal Investigator: Sule Altuncu, MD, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research 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)

May 14, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

December 31, 2026

Study Registration Dates

First Submitted

May 19, 2026

First Submitted That Met QC Criteria

May 23, 2026

First Posted (Actual)

May 29, 2026

Study Record Updates

Last Update Posted (Actual)

May 29, 2026

Last Update Submitted That Met QC Criteria

May 23, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2026-273

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because the study includes patient clinical data and no data sharing plan was specified in the approved 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

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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