Comparison Between Ultrasound Guided Pericapsular Nerve Block And Suprainguinal Fascia Iliaca Nerve Block in Hip Surgery (PENG block)

November 9, 2026 updated by: Ain Shams University

Hip fracture is a common orthopedic emergency in the elderly, and it is associated with significant morbidity and mortality. Surgical reduction and fixation are the definitive treatment in most patients, effective perioperative analgesia that minimizes the need for opioids and related adverse effects (such as delirium) is essential in this patient population.

In this study we are going to compare the effects of ultrasound guided pericapsular nerve group (PENG) block and suprainguinal fascia iliaca compartment block (FICB) on postoperative analgesia and quadriceps strength following total hip arthroplasty.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Total hip replacements (THRs) are quite successful surgery for many end-stage hip diseases in terms of pain relief and functional recovery (Lindberg-larsen M et al,2020). However, THR are associated with severe perioperative pain which prolongs length of hospitalization and increases the morbidity and medical cost (Guarino AJ et al,2019). Adequate pain management is crucial for improving the satisfaction of patients and clinical outcomes. Numerous strategies have been implemented to reduce postoperative pain following THR including local infiltration analgesia, epidural analgesia, intravenous non-steroidal anti-inflammatory agents and peripheral nerve block. (Kuchalik J et al,2017).

So, multimodal analgesia has been extensively used in perioperative period of THR (Berninger MT etal, 2019).

One of the regional anesthesia options for hip surgery is the fascia iliaca compartment block (FICB) that affects nerves important for hip innervation and sensory innervation of the thigh - femoral, obturator and lateral femoral cutaneous nerve.(Standring S,2015). FICB can be easily performed and is often a good solution for management of hip fractures in emergency departments. Its use reduces morphine pre-operative requirement for patients with femoral neck fractures and can also be indicated for hip arthroplasty, hip arthroscopy and burn management of the region (Madabushi R, 2016). A suprainguinal FICB produces a more complete sensory block of the medial, anterior and lateral region of the thigh when compared to infra-inguinal FICB. Additionally,supra-inguinal FICB leads to a more consistent spread in the cranial direction, thus spreading the anesthetic more consistently towards the lumbar plexus and three targeted nerves. So,the supra-inguinal approach has a superior postoperative analgesic efficacy compared to infra-inguinal approach along with significantly less morphine consumption in the first 24(Garner M,2017).

The pericapsular nerve group (PENG) block, which targets sensory branches of the obturator, accessory obturator, and femoral nerves in the anterior capsule of the hip, has been proposed as an effective method to treat pain associated with hip fractures and total hip arthroplasty(THA)(Giron-Arango L,2018). The PENG block provides coverage of the sensory nerves supplying the anterior hip while sparing motor blockade of the quadriceps; a known complication of fascia iliaca and femoral blocks (Tran J,2019).

PENG block has potential advantages over traditional forms of regional analgesia for pain originating from the hip, such as femoral nerve or fascia iliaca blocks. One of these potential advantages include a wider and more complete coverage of sensory nerves innervating the hip, leading to more effective regional analgesia with the potential to reduce postoperative pain,increase patient satisfaction and allow early mobilization(Bartels K,2016).

Study Type

Interventional

Enrollment (Estimated)

64

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 Contact

Study Locations

  • Egypt
    • Cairo Governorate
      • Cairo, Cairo Governorate, Egypt, 11211

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

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients scheduled for hip surgeries.
  • Age: patients aged ≥ 18 years old from both sexes.
  • Patients American Society of Anesthesiologists physical status (ASA) class I-III.

Exclusion Criteria:

  • - Refusal of procedure or participation in the study.
  • Patients suffering from allergy to local anestheics.
  • Patients with coagulation disorders or those on anticoagulant medication.
  • Infection in punctured site.
  • Classified as either American Society of Anesthesiologists (ASA) class IV-V
  • Patients suffering from cardiac condition,dementia or cognitive impairment, liver failure, renal insufficiency and pre-existing neurologic deficits.

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: group P

patients receiving Peng block.
Procedure: PENG

patients receiving Peng block.
Experimental: Group F

patients receiving suprainguinal Fascia iliaca block.
Procedure: Fascia iliaca

patients receiving suprainguinal Fascia iliaca block

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
pain score(VAS score)
Time Frame: 24 hour

The primary outcome measure was pain scores(VAS score) from 0(no pain) till 10 severe pain
24 hour

Collaborators and Investigators

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

Sponsor

Ain Shams University

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)

January 1, 2022

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

November 4, 2026

First Submitted That Met QC Criteria

November 9, 2026

First Posted (Actual)

November 12, 2026

Study Record Updates

Last Update Posted (Actual)

November 12, 2026

Last Update Submitted That Met QC Criteria

November 9, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • Hip Surgery Block

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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