MRI-Based Assessment of Local Anesthetic Spread in the PENG Block Compartment

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

6 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-30

Study Completion Date

2026-10-31

Brief Summary

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This study uses MRI imaging to evaluate the spread of local anesthetic following the administration of a pericapsular nerve group (PENG) block. The goal is to determine whether a distinct fascial plane exists between neurovascular structures, potentially explaining the block's observed clinical effectiveness.

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Detailed Description

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The pericapsular nerve group (PENG) block has demonstrated promising clinical results in providing analgesia for hip-related pain, particularly in patients with femoral neck fractures or undergoing hip surgery. However, the exact mechanism of action and spread of local anesthetic remain poorly understood. This pilot study aims to use magnetic resonance imaging (MRI) to visualize the distribution pattern of the injectate after PENG block administration.

High-resolution MRI scans will be obtained shortly after the procedure to assess the spatial relationship between the spread of local anesthetic, relevant anatomical structures (including the iliopsoas muscle, femoral artery, and femoral nerve), and potential fascial compartments. The findings will help to clarify the anatomic basis of the PENG block and may guide optimization of technique for enhanced clinical outcomes.

Conditions

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Total Hip Arthroplasty (THA) Postoperative Pain Management After Total Hip Arthroplasty

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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PENG Block with MRI-Based Local Anesthetic Spread Assessment

All patients receive standardized multimodal analgesia before surgery. Patients in this arm receive an ultrasound-guided PENG block in the supine position under sterile conditions. A low-frequency (2-5 MHz) curvilinear probe is placed above the AIIS and rotated \~45° to align with the pubic ramus. Using an in-plane lateral-to-medial approach, a 10 cm, 20G needle is advanced to the interfascial plane between the iliopsoas tendon and pubic ramus. After negative aspiration, ropivacaine hydrochloride 0.5% is injected in 5 mL increments up to 20 mL, observing spread via ultrasound. A pelvic MRI is then performed to assess anesthetic diffusion before the patient proceeds to total hip arthroplasty.

Group Type EXPERIMENTAL

PENG Block

Intervention Type PROCEDURE

Preoperative ultrasound giuded PENG block (ropivacaine 0,5% 20mL)

Magnetic resonance imaging

Intervention Type PROCEDURE

The patient will undergo a pelvic MRI to assess anesthetic diffusion after PENG block

Interventions

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PENG Block

Preoperative ultrasound giuded PENG block (ropivacaine 0,5% 20mL)

Intervention Type PROCEDURE

Magnetic resonance imaging

The patient will undergo a pelvic MRI to assess anesthetic diffusion after PENG block

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients scheduled for total hip replacement surgery
* Age ≥ 18 years
* ASA physical status classification I-III
* Signed informed consent obtained
* Orthopedic indication for preoperative MRI study

Exclusion Criteria

* Allergy to local anesthetics
* Infection at the planned puncture site
* Refusal or inability to provide informed consent
* Age \< 18 years
* Claustrophobia
* Altered consciousness or severe dementia
* Presence of MRI-incompatible implanted devices (e.g., pacemakers implanted before 2000)
* Pregnancy or breastfeeding

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No