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PENG Block + LIA For Endoprosthesis Surgery

Sponsor: ASST Gaetano Pini-CTO • ClinicalTrials.gov ID: NCT07239817

Registry updated: 2026-09-22

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Description

The goal of this clinical trial is to learn if a new local anesthesia technique can control pain as well as the standard spinal anesthesia for adults having hip endoprosthesis surgery. The main questions it aims to answer are: * Is the new local anesthesia technique as effective as standard spinal anesthesia in managing pain during the first two days after surgery? * Does the new technique allow participants to move their leg sooner after the operation? Researchers will compare the new local anesthesia technique (numbing medicine injected directly around the hip joint) to standard spinal anesthesia (a numbing injection in the back) to see if the new technique works just as well for pain control while possibly causing fewer side effects like nausea. Participants who join this study will be randomly placed into one of two groups. One group will receive the standard spinal anesthesia before their surgery. The other group will receive the new local anesthesia technique before their surgery. After the operation, researchers will track the amount of extra pain medicine each participant uses and will check their ability to move their hip, knee, and foot.

Interventions

Pericapsular Nerve Group Blocks with Local Infiltration Analgesia (Procedure)
An ultrasound-guided, motor-sparing regional anesthesia procedure. It involves three distinct injections: 1) An anterior Pericapsular Nerve Group (A-PENG) block targeting the sensory articular branches of the femoral and obturator nerves. 2) A Local Infiltration Analgesia (LIA) of the surgical incision line. 3) A posterior PENG (PONG) block targeting sensory branches from the sciatic plexus. The local anesthetic mixture consists of ropivacaine, mepivacaine with epinephrine, and dexamethasone in specific volumes for each injection site.
spinal anesthesia (Procedure)
Standard neuraxial anesthesia technique involving the injection of a local anesthetic into the subarachnoid space. The procedure is performed according to the institution's standard clinical practice. The choice of the specific local anesthetic agent, dose, and technique will be at the discretion of the attending anesthesiologist, based on the participant's clinical characteristics.

Eligibility criteria

Inclusion Criteria: * Provision of signed and dated informed consent form. * Scheduled for hip endoprosthesis surgery for femoral fracture with an anterior, lateral or posterolateral approach (any approach). * Age 18 years or older. * Willing and able to comply with the study protocol. Exclusion Criteria: * Failure to provide informed consent. * Age less than 18 years. * Known allergy to local anesthetics or other medications used in the protocol. * Presence of infection at the planned injection site. * Pre-existing hip prosthesis or prior major surgery on the same hip (e.g., revision surgery). * ASA physical status class \> IV. * Administration of intraoperative opiates or conversion to general anesthesia.

Conditions

Hip Fractures Arthroplasty, Replacement, Hip Pain, Postoperative Anesthesia and Analgesia Nerve Block Local Anesthesia Infiltration

Locations

Gaetano Pini-CTO — Milan, Italy

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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