Recruiting

PENG Block vs. Infiltration

Sponsor:

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Code:

NCT05898581

Conditions

Anesthesia

Eligibility Criteria

Sex: All

Age: 19+

Healthy Volunteers: Not accepted

Interventions

PENG Block

Control Group

Study Details

Brief summary:

Currently, the analgesic standard of care for patients undergoing total hip arthroplasty (THA) at our centre is intraoperative infiltration with a solution of local anesthetic, morphine (opioid), and ketorolac (nonsteroidal anti-inflammatory drug - NSAID). If a patient has a contraindication for the use of an opioid or NSAIDs, this infiltration is performed with a plain local anesthetic. No blocks (numbing of certain nerves to prevent pain from occurring in that area) are performed for postoperative pain in these patients. The pericapsular nerve group (PENG) block is a recently described technique with limited data in the literature that has assessed the benefits of using this nerve block for THA procedures. The purpose of this study is to investigate if the ultrasound-guided PENG block can provide non-inferior postoperative analgesia compared to local intraoperative anesthetic infiltration (ILAI) with an associated cost benefit for patients undergoing THA.

Conditions

Anesthesia

Study ID

NCT05898581

Start date

Nov 1, 2024

Status verified date

Sep, 2025

Completion date

Jul 1, 2026

Anticipated

Primary completion date

Jun 30, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 19+

Healthy Volunteers: Not accepted

Inclusion Criteria:

1. Adult patient (>18 years old)
2. Undergoing THA with a direct lateral surgical approach (transgluteal approach)
3. Ability to provide verbal/written consent to participate in this trial

Exclusion Criteria:

1. Patient with any contraindication for spinal anesthesia
2. Patient with any contraindication for regional analgesia
3. Patient undergoing THA with a direct anterior surgical approach
4. Patients undergoing THA for hip revision
5. Patients undergoing THA under One Day Stay (ODS) admission
6. Patients that received opioids intrathecally
7. Patients having residual motor block six hours after the completion of the spinal anesthesia.
8. Patients with a history of regular opioid intake for more than three months
9. Patients incapable of performing knee extension of the same operative side
10. Pregnant patients

Study Design

Enrollment

60 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: PENG Block

Participants will receive ultrasound-guided PENG block (PENG group) with local anesthetics (20 ml of 0.5% ropivacaine) before administration of spinal anesthesia. Patients in this group will also receive a sham ILAI procedure with 60 mL of saline (performed by the operating surgeon).

sham comparator: Control Group

Participants will receive a sham PENG block performed with 20ml of normal saline solution before spinal anesthesia. After, patients will receive ILAI (performed by the operating surgeon) with a plain solution of ropivacaine 0.25% 60ml.

Interventions

PENG Block

Participants will receive a PENG block with local anesthetics (which is a freezing medication, in this case, 0.5% ropivacaine) before receiving spinal anesthesia. Patients in this group will also receive a sham ILAI procedure with 60 mL of saline (performed by the operating surgeon).

Control Group

Participants will receive a sham PENG block performed with 20ml of normal saline solution before spinal anesthesia. After, patients will receive ILAI (performed by the operating surgeon) with a plain solution of ropivacaine 0.25% 60ml.

Primary outcome measure

  • PENG block impact on post-operative pain scores [ Time Frame: 8-24 hours following completion of spinal anesthesia ]

Central Contacts and Locations

Central contacts

Shalini Dhir, FRCPC

519-685-8500shalini.dhir@sjhc.london.on.ca

Rodrigo Araujo Monteiro da Silva, MD

519-685-8500rodrigo.araujomonteirodasilva@lhsc.on.ca

Locations

London Health Sciences Centre

Recruiting

London, Ontario, Canada

More Information

Sponsor

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Last update posted

Sep 18, 2025

Last verified

Sep, 2025

Keywords

  • anesthesia
  • total hip arthroplasty
  • Pericapsular Nerve Group Block

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's on 2025-09-18.