Perioperative Analgesic Effects of PENG Versus PENG Plus LFCN Block in Hip Surgeries

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

72 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-01

Study Completion Date

2026-07-01

Brief Summary

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This study is designed to find the best way to control pain after hip surgery performed through a side (lateral) incision. Two different types of nerve blocks used before the operation will be compared.

In one group, patients will receive a Pericapsular Nerve Group (PENG) block, which numbs the main nerves that carry pain signals from the hip joint. In the other group, patients will receive a PENG block together with a Lateral Femoral Cutaneous Nerve (LFCN) block, which adds extra pain relief for the skin and outer part of the thigh.

A total of 72 patients between 18 and 80 years old will take part in this study. All operations will be done under spinal anesthesia. Pain levels will be measured several times during the first 24 hours after surgery using a simple 0-10 pain scale. Patients will receive pain medicine through a pump that allows them to press a button when they feel pain. The total amount of medicine used will be recorded.

The researchers will also monitor when patients first need pain medicine, when they can start walking, how satisfied they are with pain control, and if they experience side effects such as nausea or dizziness.

By comparing the two methods, the study aims to see whether adding the LFCN block to the PENG block provides better pain control, lower drug use, faster recovery, and higher patient comfort after hip surgery.

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Detailed Description

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Postoperative pain following hip surgery remains a significant clinical challenge, particularly in procedures performed through a lateral incision, where both deep articular and superficial cutaneous pain components contribute to patient discomfort. Effective regional anesthesia techniques are essential to optimize postoperative analgesia, facilitate early mobilization, and reduce opioid-related adverse effects.

The Pericapsular Nerve Group (PENG) block has been introduced as a motor-sparing regional anesthesia technique targeting the articular branches of the femoral, obturator, and accessory obturator nerves, providing effective analgesia for hip joint-related pain. However, due to its limited coverage of cutaneous innervation, patients undergoing lateral incision hip surgery may continue to experience residual superficial pain.

The Lateral Femoral Cutaneous Nerve (LFCN) block selectively targets the sensory innervation of the anterolateral thigh and may complement the PENG block by addressing the cutaneous component of postoperative pain. The combined use of PENG and LFCN blocks has the potential to provide more comprehensive analgesia without compromising motor function.

This study is designed to evaluate whether the addition of an LFCN block to a standard PENG block enhances postoperative pain control and recovery outcomes in patients undergoing hip surgery via a lateral approach. By comparing these two regional anesthesia strategies, the study aims to contribute evidence-based guidance for optimizing multimodal analgesia protocols in hip surgery.

Conditions

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HİP FRACTURE Hip Surgery (Lateral Incision) Postoperative Pain Management Analgesia, Postoperative Regional Anesthesia Success

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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PENG BLOCK GROUP

An ultrasound-guided Pericapsular Nerve Group (PENG) block will be performed preoperatively using standard local anesthetic techniques to provide postoperative analgesia in patients undergoing lateral incision hip surgery.

Group Type EXPERIMENTAL

Pericapsular nerve group (PENG) block

Intervention Type PROCEDURE

An ultrasound-guided Pericapsular Nerve Group (PENG) block will be performed preoperatively using standard local anesthetic techniques to provide postoperative analgesia in patients undergoing lateral incision hip surgery.

PENG + LFCN BLOCK GROUP

Patients in this group will receive a preoperative ultrasound-guided Pericapsular Nerve Group (PENG) block combined with a Lateral Femoral Cutaneous Nerve (LFCN) block for postoperative analgesia prior to lateral incision hip surgery under spinal anesthesia.

Group Type EXPERIMENTAL

Pericapsular nerve group (PENG) block

Intervention Type PROCEDURE

An ultrasound-guided Pericapsular Nerve Group (PENG) block will be performed preoperatively using standard local anesthetic techniques to provide postoperative analgesia in patients undergoing lateral incision hip surgery.

Lateral Femoral Cutaneous Nerve (LFCN) Block

Intervention Type PROCEDURE

An ultrasound-guided Lateral Femoral Cutaneous Nerve (LFCN) block will be performed preoperatively as an adjunct to the PENG block to enhance postoperative analgesia in patients undergoing lateral incision hip surgery.

Interventions

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Pericapsular nerve group (PENG) block

An ultrasound-guided Pericapsular Nerve Group (PENG) block will be performed preoperatively using standard local anesthetic techniques to provide postoperative analgesia in patients undergoing lateral incision hip surgery.

Intervention Type PROCEDURE

Lateral Femoral Cutaneous Nerve (LFCN) Block

An ultrasound-guided Lateral Femoral Cutaneous Nerve (LFCN) block will be performed preoperatively as an adjunct to the PENG block to enhance postoperative analgesia in patients undergoing lateral incision hip surgery.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients aged between 18 and 80 years
* Patients scheduled for elective or trauma-related hip surgery performed through a lateral incision under spinal anesthesia
* Patients receiving a preoperative ultrasound-guided Pericapsular Nerve Group (PENG) block or a PENG block combined with a Lateral Femoral Cutaneous Nerve (LFCN) block
* American Society of Anesthesiologists (ASA) physical status I-III
* Patients with full orientation and the ability to cooperate
* Ability to understand the study procedures and provide written informed consent

Exclusion Criteria

* Contraindications to regional anesthesia, including coagulopathy or local infection at the injection site
* Presence of neuropathic disorders or conditions that may affect pain perception, including chronic analgesic use
* Requirement for conversion to general anesthesia
* Postoperative admission to the intensive care unit
* Known allergy or hypersensitivity to opioids or local anesthetics
* American Society of Anesthesiologists (ASA) physical status IV-V

Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No