Comparison of Femoral Nerve Block and Combined PENG Plus Femoral Nerve Block in Geriatric Hip Surgery
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age65+
SponsorAnkara City Hospital Bilkent
About this trial
Hip fracture surgery in geriatric patients is frequently associated with severe perioperative pain, which may complicate positioning for spinal anesthesia and increase perioperative opioid requirements. Regional analgesic techniques are commonly used to improve patient comfort and reduce opioid consumption in this vulnerable population. The femoral nerve block is a well-established method for analgesia in hip surgery, while the pericapsular nerve group (PENG) block has emerged as a novel technique targeting articular branches of the hip joint with potential advantages in pain control.
This prospective randomized controlled trial aims to compare the analgesic efficacy of femoral nerve block alone versus a combined pericapsular nerve group (PENG) plus femoral nerve block in geriatric patients undergoing hip fracture surgery under spinal anesthesia. The primary outcomes include perioperative pain intensity, opioid consumption within the first 24 hours postoperatively, and the need for additional analgesia during positioning for spinal anesthesia. Secondary outcomes include spinal anesthesia procedure duration, time to sensory block onset, time to first postoperative opioid requirement, and perioperative hemodynamic parameters.
The results of this study are expected to clarify whether the addition of the PENG block to femoral nerve block provides superior perioperative analgesia and improved patient comfort compared with femoral nerve block alone in geriatric hip fracture surgery.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age 65 years and older,
Patients scheduled for surgery due to hip fracture,
American Society of Anesthesiologists (ASA) physical status I-III,
Body mass index between 18 and 40 kg/m²,
Disqualifiers
Age below 65 years,
Refusal to participate in the study,
Severe cognitive impairment, dementia, or Alzheimer's disease,
ASA physical status IV or higher,
Trial design
Design model
Parallel
Treatments tested in this trial
Pericapsular nerve group (PENG) block plus femoral nerve block
Procedure/SurgeryCombination of ultrasound-guided pericapsular nerve group (PENG) block and femoral nerve block performed preoperatively approximately 30 minutes before surgery using 20 mL of 0.25% bupivacaine for each block for perioperative analgesia.
Femoral Nerve Block
Procedure/SurgeryUltrasound-guided femoral nerve block performed preoperatively approximately 30 minutes before surgery using 20 mL of 0.25% bupivacaine for perioperative analgesia.
Treatment groups
68 Participants
are divided into 2 treatment groupsGroup A: Femoral Nerve BlockExperimental treatment 1 intervention
Group B: PENG Block + Femoral Nerve BlockExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Pain Score During Positioning for Spinal Anesthesia
To compare pain intensity during patient positioning for spinal anesthesia between the Femoral Nerve Block group and the combined Pericapsular Nerve Group (PENG) + Femoral Nerve Block group. Pain will be assessed using the Visual Analog Scale (VAS) at the time of lateral decubitus positioning for spinal anesthesia. The need for additional intravenous fentanyl during positioning will also be recorded.
Time frame
Periprocedural: from initiation of lateral decubitus positioning for spinal anesthesia to completion of the spinal anesthetic procedure (needle withdrawal following intrathecal injection).Secondary outcomes
1
Postoperative Pain Scores Within the First 24 Hours
To compare postoperative pain intensity between the Femoral Nerve Block group and the combined Pericapsular Nerve Group (PENG) + Femoral Nerve Block group using the Visual Analog Scale (VAS). Pain scores will be assessed at rest and during movement at postoperative 0, 2, 8, 16, and 24 hours.
Time frame
Within the first 24 hours postoperatively2
Total Opioid Consumption Within the First 24 Hours
To compare total intravenous opioid consumption between groups within the first 24 postoperative hours. Opioid use will be recorded as cumulative tramadol consumption (mg) administered as rescue analgesia.
Time frame
Within the first 24 hours postoperatively.3
Hemodynamic Stability During Perioperative Period
To compare perioperative hemodynamic parameters including heart rate, systolic, diastolic, and mean arterial blood pressure, and peripheral oxygen saturation (SpO₂) between groups during the block procedure, intraoperative period, and the first 24 postoperative hours.
Time frame
From block application to 24 hours postoperativelySponsors and contacts
Click on the lead sponsor to view all of their trials.
Ankara City Hospital Bilkent
Lead sponsor
Ankara Bilkent Sehir Hastanesi
Sponsor institution
Source ClinicalTrials.gov