Trial Outcomes & Findings for The Ultrasound Guided Pericapsular Nerve Group and Anterior Quadratus Lumborum Blocks in Hip Replacement Surgeries (NCT NCT06679764)

Results Overview

Total dose of IV morphine (mg) administered as rescue analgesia during the first 24 postoperative hours. Morphine 0.05 mg/kg IV boluses were given when NRS ≥4, up to a maximum of 0.3 mg/kg/24 h. Reported as median (IQR).

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

93 participants

Primary outcome timeframe

Immediatly post operative for 24 hours

Results posted on

2026-01-30

Participant Flow

Elderly patients (≥65 years) with traumatic hip fractures scheduled for elective unilateral total hip arthroplasty via an anterolateral approach under general anesthesia were recruited at the Orthopedic Surgical Theater, Cairo University Hospital. Recruitment occurred at a single tertiary university hospital in Egypt.

No wash-out or run-in phase. All eligible, consenting patients were randomized 1:1:1 immediately before surgery after induction of general anesthesia. No participants were excluded after enrollment and before assignment to study arms.

Participant milestones

Participant milestones
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Overall Study STARTED	31	31	31
Overall Study COMPLETED	31	31	31
Overall Study NOT COMPLETED	0	0	0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.	Total n=93 Participants Total of all reporting groups
Age, Categorical <=18 years	0 Participants n=31 Participants	0 Participants n=31 Participants	0 Participants n=31 Participants	0 Participants n=93 Participants
Age, Categorical Between 18 and 65 years	0 Participants n=31 Participants	0 Participants n=31 Participants	0 Participants n=31 Participants	0 Participants n=93 Participants
Age, Categorical >=65 years	31 Participants n=31 Participants	31 Participants n=31 Participants	31 Participants n=31 Participants	93 Participants n=93 Participants
Sex: Female, Male Female	17 Participants n=31 Participants	18 Participants n=31 Participants	12 Participants n=31 Participants	47 Participants n=93 Participants
Sex: Female, Male Male	14 Participants n=31 Participants	13 Participants n=31 Participants	19 Participants n=31 Participants	46 Participants n=93 Participants
Race and Ethnicity Not Collected	—	—	—	0 Participants Race and Ethnicity were not collected from any participant.
Region of Enrollment Egypt	31 Participants n=31 Participants	31 Participants n=31 Participants	31 Participants n=31 Participants	93 Participants n=93 Participants
Age	68.74 years STANDARD_DEVIATION 3.32 • n=31 Participants	70.87 years STANDARD_DEVIATION 4.74 • n=31 Participants	69.55 years STANDARD_DEVIATION 2.59 • n=31 Participants	69.72 years STANDARD_DEVIATION 3.73 • n=93 Participants

PRIMARY outcome

Timeframe: Immediatly post operative for 24 hours

Population: All randomized participants (N=93; 31 per group) received the allocated intervention and completed 24-hour follow-up; no losses to follow-up and no exclusions from analysis. Primary outcome data were available for all participants; analysis was performed on the full randomized set (intention-to-treat).

Total dose of IV morphine (mg) administered as rescue analgesia during the first 24 postoperative hours. Morphine 0.05 mg/kg IV boluses were given when NRS ≥4, up to a maximum of 0.3 mg/kg/24 h. Reported as median (IQR).

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
The Total Amount of Morphine Consumption	6.0 mg of IV morphine Interval 3.5 to 8.0	8.0 mg of IV morphine Interval 6.0 to 11.0	12.0 mg of IV morphine Interval 10.5 to 12.0

SECONDARY outcome

Timeframe: 30 minutes, 2, 4, 6, 8, 12, 18, and 24 hours after surgery

Pain intensity at rest using 0-10 Numeric Pain Rating Scale (0 = no pain, 10 = worst imaginable pain) measured at specified time points; data reported as median (IQR).

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Numeric Pain Rating Scale at Rest Over First 24 Hours 30 min	0.0 units on a scale Interval 0.0 to 0.0	1.0 units on a scale Interval 0.0 to 1.0	2.0 units on a scale Interval 2.0 to 3.0
Numeric Pain Rating Scale at Rest Over First 24 Hours 2 h	1.0 units on a scale Interval 0.0 to 1.0	1.0 units on a scale Interval 0.0 to 1.0	2.0 units on a scale Interval 1.0 to 6.0
Numeric Pain Rating Scale at Rest Over First 24 Hours 4 h	1.0 units on a scale Interval 1.0 to 2.0	2.0 units on a scale Interval 0.0 to 2.0	3.0 units on a scale Interval 2.0 to 3.0
Numeric Pain Rating Scale at Rest Over First 24 Hours 6 h	2.0 units on a scale Interval 1.0 to 2.0	2.0 units on a scale Interval 1.0 to 3.0	2.0 units on a scale Interval 1.0 to 3.0
Numeric Pain Rating Scale at Rest Over First 24 Hours 8 h	2.0 units on a scale Interval 2.0 to 3.0	3.0 units on a scale Interval 2.0 to 4.0	3.0 units on a scale Interval 2.0 to 4.0
Numeric Pain Rating Scale at Rest Over First 24 Hours 12 h	3.0 units on a scale Interval 2.0 to 3.0	3.0 units on a scale Interval 3.0 to 4.0	3.0 units on a scale Interval 2.0 to 3.0
Numeric Pain Rating Scale at Rest Over First 24 Hours 18 h	3.0 units on a scale Interval 2.0 to 3.0	3.0 units on a scale Interval 3.0 to 4.0	3.0 units on a scale Interval 2.0 to 4.0
Numeric Pain Rating Scale at Rest Over First 24 Hours 24 h	3.0 units on a scale Interval 3.0 to 3.0	3.0 units on a scale Interval 3.0 to 4.0	3.0 units on a scale Interval 2.0 to 3.0

SECONDARY outcome

Timeframe: at 30 minutes, 2, 4, 6, 8, 12, 18 and 24 hours postoperatively

Pain intensity during passive 90° hip flexion using 0-10 NRS at same time points; reported as median (IQR).

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Numeric Pain Rating Scale During Passive 90° Hip Flexion Over First 24 Hours 30 min	1.0 units on a scale Interval 1.0 to 1.0	1.0 units on a scale Interval 0.0 to 2.0	3.0 units on a scale Interval 3.0 to 3.0
Numeric Pain Rating Scale During Passive 90° Hip Flexion Over First 24 Hours 2 h	2.0 units on a scale Interval 1.0 to 2.0	1.0 units on a scale Interval 0.0 to 2.0	5.0 units on a scale Interval 3.0 to 7.0
Numeric Pain Rating Scale During Passive 90° Hip Flexion Over First 24 Hours 4 h	2.0 units on a scale Interval 2.0 to 3.0	2.0 units on a scale Interval 1.0 to 3.0	3.0 units on a scale Interval 3.0 to 4.0
Numeric Pain Rating Scale During Passive 90° Hip Flexion Over First 24 Hours 6 h	3.0 units on a scale Interval 2.0 to 3.0	3.0 units on a scale Interval 1.0 to 3.0	3.0 units on a scale Interval 3.0 to 7.0
Numeric Pain Rating Scale During Passive 90° Hip Flexion Over First 24 Hours 8 h	3.0 units on a scale Interval 3.0 to 3.0	3.0 units on a scale Interval 2.0 to 4.0	5.0 units on a scale Interval 3.0 to 6.0
Numeric Pain Rating Scale During Passive 90° Hip Flexion Over First 24 Hours 12 h	3.0 units on a scale Interval 3.0 to 4.0	3.0 units on a scale Interval 3.0 to 4.0	3.0 units on a scale Interval 3.0 to 3.0
Numeric Pain Rating Scale During Passive 90° Hip Flexion Over First 24 Hours 18 h	3.0 units on a scale Interval 3.0 to 4.0	4.0 units on a scale Interval 3.0 to 5.0	5.0 units on a scale Interval 4.0 to 7.0
Numeric Pain Rating Scale During Passive 90° Hip Flexion Over First 24 Hours 24 h	3.0 units on a scale Interval 3.0 to 4.0	3.0 units on a scale Interval 3.0 to 4.0	3.0 units on a scale Interval 3.0 to 4.0

SECONDARY outcome

Timeframe: Immediatly post operative for 24 hours

Time from arrival in PACU to first administration of IV morphine rescue dose (NRS ≥4). Reported as median (IQR).

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Time to First Rescue Morphine Analgesia	12.0 Hours Interval 6.0 to 18.0	8.0 Hours Interval 7.0 to 12.0	2.0 Hours Interval 2.0 to 4.0

SECONDARY outcome

Timeframe: 30 minutes, 2, 4, 6, 8, 12, 18 and 24 hours postoperatively

Manual muscle test (0-5 scale; 0 = no contraction, 5 = full ROM against gravity and maximal resistance) for quadriceps and iliopsoas muscles on the operated side, after extubation, at predefined time points.

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Manual Muscle Test (MMT) Score for Quadriceps/Iliopsoas Over First 24 Hours 30 min	1.0 units on a scale Interval 0.0 to 1.0	2.0 units on a scale Interval 2.0 to 2.0	0.0 units on a scale Interval 0.0 to 2.0
Manual Muscle Test (MMT) Score for Quadriceps/Iliopsoas Over First 24 Hours 2 h	1.0 units on a scale Interval 1.0 to 1.0	3.0 units on a scale Interval 3.0 to 3.0	1.0 units on a scale Interval 1.0 to 1.0
Manual Muscle Test (MMT) Score for Quadriceps/Iliopsoas Over First 24 Hours 4 h	2.0 units on a scale Interval 2.0 to 2.0	3.0 units on a scale Interval 3.0 to 4.0	2.0 units on a scale Interval 2.0 to 3.0
Manual Muscle Test (MMT) Score for Quadriceps/Iliopsoas Over First 24 Hours 6 h	2.0 units on a scale Interval 2.0 to 3.0	4.0 units on a scale Interval 4.0 to 4.0	3.0 units on a scale Interval 2.0 to 4.0
Manual Muscle Test (MMT) Score for Quadriceps/Iliopsoas Over First 24 Hours 8 h	3.0 units on a scale Interval 3.0 to 3.0	4.0 units on a scale Interval 4.0 to 4.0	3.0 units on a scale Interval 3.0 to 4.0
Manual Muscle Test (MMT) Score for Quadriceps/Iliopsoas Over First 24 Hours 12 h	3.0 units on a scale Interval 3.0 to 3.0	4.0 units on a scale Interval 4.0 to 4.0	4.0 units on a scale Interval 3.0 to 4.0
Manual Muscle Test (MMT) Score for Quadriceps/Iliopsoas Over First 24 Hours 18 h	3.0 units on a scale Interval 3.0 to 4.0	4.0 units on a scale Interval 4.0 to 4.0	4.0 units on a scale Interval 4.0 to 4.0
Manual Muscle Test (MMT) Score for Quadriceps/Iliopsoas Over First 24 Hours 24 h	4.0 units on a scale Interval 4.0 to 4.0	4.0 units on a scale Interval 4.0 to 4.0	4.0 units on a scale Interval 4.0 to 4.0

SECONDARY outcome

Timeframe: 30 minutes, 2, 4, 6, 8, 12, 18 and 24 hours postoperatively

Active hip flexion range of motion (degrees) of the operated hip, from 0° to 90°, assessed at same time points as MMTe. Reported as median (IQR).

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Active Hip Flexion Range of Motion (0°-90°) Over First 24 Hours 30 min	0.0 Degrees of hip flexion Interval 0.0 to 0.0	20.0 Degrees of hip flexion Interval 10.0 to 20.0	0.0 Degrees of hip flexion Interval 0.0 to 10.0
Active Hip Flexion Range of Motion (0°-90°) Over First 24 Hours 2 h	0.0 Degrees of hip flexion Interval 0.0 to 0.0	30.0 Degrees of hip flexion Interval 20.0 to 45.0	20.0 Degrees of hip flexion Interval 0.0 to 20.0
Active Hip Flexion Range of Motion (0°-90°) Over First 24 Hours 4 h	0.0 Degrees of hip flexion Interval 0.0 to 20.0	45.0 Degrees of hip flexion Interval 30.0 to 45.0	30.0 Degrees of hip flexion Interval 20.0 to 45.0
Active Hip Flexion Range of Motion (0°-90°) Over First 24 Hours 6 h	0.0 Degrees of hip flexion Interval 0.0 to 20.0	45.0 Degrees of hip flexion Interval 45.0 to 45.0	45.0 Degrees of hip flexion Interval 30.0 to 45.0
Active Hip Flexion Range of Motion (0°-90°) Over First 24 Hours 8 h	30.0 Degrees of hip flexion Interval 20.0 to 45.0	90.0 Degrees of hip flexion Interval 45.0 to 90.0	45.0 Degrees of hip flexion Interval 30.0 to 45.0
Active Hip Flexion Range of Motion (0°-90°) Over First 24 Hours 12 h	45.0 Degrees of hip flexion Interval 45.0 to 45.0	90.0 Degrees of hip flexion Interval 90.0 to 90.0	45.0 Degrees of hip flexion Interval 45.0 to 60.0
Active Hip Flexion Range of Motion (0°-90°) Over First 24 Hours 18 h	45.0 Degrees of hip flexion Interval 45.0 to 45.0	90.0 Degrees of hip flexion Interval 90.0 to 90.0	45.0 Degrees of hip flexion Interval 45.0 to 60.0
Active Hip Flexion Range of Motion (0°-90°) Over First 24 Hours 24 h	90.0 Degrees of hip flexion Interval 45.0 to 90.0	90.0 Degrees of hip flexion Interval 90.0 to 90.0	45.0 Degrees of hip flexion Interval 45.0 to 90.0

SECONDARY outcome

Timeframe: During surgery

Total dose of IV fentanyl administered intraoperatively. Additional boluses of 1 μg/kg were given if MAP or HR increased by \>20% above baseline. Reported as mean ± SD.

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Total Intraoperative Fentanyl Dose	142.58 μg fentanyl Standard Deviation 18.43	152.90 μg fentanyl Standard Deviation 60.23	236.61 μg fentanyl Standard Deviation 90.68

SECONDARY outcome

Timeframe: From end of surgery until first walk (within postoperative 24 h)

Time from end of surgery to first ambulation (≥3 steps with walker). Reported as median (IQR)

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Time to First Walk	24.0 Hours Interval 18.0 to 24.0	8.0 Hours Interval 8.0 to 12.0	18.0 Hours Interval 12.0 to 24.0

SECONDARY outcome

Timeframe: From date of surgery until discharge

Time from surgery to hospital discharge. Reported as mean ± SD.

Outcome measures

Outcome measures
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 Participants Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 Participants Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 Participants General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Length of Hospital Stay	3.16 Days Standard Deviation 0.52	2.13 Days Standard Deviation 0.34	2.94 Days Standard Deviation 0.68

Adverse Events

Anterior Quadratus Lumborum Block Technique (AQLB)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Pericapsular Nerve Group (PENG) Block

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Control Group

Serious events: 0 serious events

Other events: 7 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure	Anterior Quadratus Lumborum Block Technique (AQLB) n=31 participants at risk Single-shot ultrasound-guided anterior quadratus lumborum block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between quadratus lumborum and psoas major muscles using an in-plane posterior-to-anterior approach.	Pericapsular Nerve Group (PENG) Block n=31 participants at risk Single-shot ultrasound-guided pericapsular nerve group (PENG) block performed after induction of GA. 30 mL local anesthetic mixture (29 mL 0.25% bupivacaine + 1 mL dexamethasone 4 mg) injected in the fascial plane between iliopsoas tendon and superior pubic ramus under ultrasound guidance.	Control Group n=31 participants at risk General anesthesia without regional block. Intraoperative fentanyl administered as required; post-operative IV morphine (0.05 mg/kg boluses, maximum 0.3 mg/kg/24 h) as rescue analgesia within a multimodal regimen including IV paracetamol.
Gastrointestinal disorders Postoperative nausea and vomiting	0.00% 0/31 • Intraoperative period and first 24 postoperative hours through discharge up to 4 days Adverse events were prospectively monitored intraoperatively and during the first 24 h postoperatively. Predefined events included block-related complications (sedation, hallucination, respiratory depression, hematoma, lower limb weakness, hypotension, falls) and morphine-related postoperative nausea and vomiting (PONV).	0.00% 0/31 • Intraoperative period and first 24 postoperative hours through discharge up to 4 days Adverse events were prospectively monitored intraoperatively and during the first 24 h postoperatively. Predefined events included block-related complications (sedation, hallucination, respiratory depression, hematoma, lower limb weakness, hypotension, falls) and morphine-related postoperative nausea and vomiting (PONV).	22.6% 7/31 • Number of events 7 • Intraoperative period and first 24 postoperative hours through discharge up to 4 days Adverse events were prospectively monitored intraoperatively and during the first 24 h postoperatively. Predefined events included block-related complications (sedation, hallucination, respiratory depression, hematoma, lower limb weakness, hypotension, falls) and morphine-related postoperative nausea and vomiting (PONV).

Additional Information

Dr. Alaa F. Abd Elbadei - Corresponding Author

Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.

Phone: 01222224057

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place