Hip SurgeryPENG vs QLBNCT06653894
Postoperative Analgesic Efficacy of PENG and QLB Blocks in Hip Surgeries
A study testing PENG block with 0.25% bupivacaine. and anterior quadratus lumborum block in people with Hip Surgery and Postoperative Analgesia, run by Gaziosmanpasa Research and Education Hospital at 1 site in Turkey (Türkiye).
Trial summary
This prospective, randomized, single-blinded study compares the postoperative analgesic efficacy of the Pericapsular Nerve Group (PENG) block and Quadratus Lumborum Block (QLB) in hip surgeries under spinal anesthesia. Read more about this study
- Who is it for?
- Ages 40 years and older
- Conditions the study is for
- Hip Surgery, Postoperative Analgesia
- What is being tested?
- PENG block with 0.25% bupivacaine. and anterior quadratus lumborum block
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 73 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 25 Oct 2024to 3 Apr 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- "Patients aged over 40 years who are scheduled to undergo hip surgery under spinal anesthesia and classified as ASA 1-3 will be included in the study."
Who cannot join
- Patients who refuse the procedure.
- Patients who will receive general anesthesia or peripheral nerve blocks such as a combination of femoral and sciatic nerve blocks.
- A history of allergy to local anesthetic agents.
- Patients with a diagnosis of neurocognitive disorders such as dementia or Alzheimer's disease under active neurological follow-up.
- Patients with multiple trauma.
- Patients with severe hearing or vision impairments.
Show all 10Show fewer
- Patients with a local infection at the site of the block application.
- Patients with a Body Mass Index (BMI) > 35.
- Patients with a history of severe neurological, cardiovascular, renal, or hepatic disease will be excluded from the study.
- Patients who, during the postoperative period, required intensive care unit (ICU) admission for more than one day due to hemodynamic monitoring or sedation, as well as those who developed complications during postoperative follow-up-such as re-operation, postoperative hemorrhage, or the need for advanced cardiopulmonary support-were excluded from the study.
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Gaziosmanpasa Research and Education Hospital
Istanbul, 34255
About this study
Official title: Evaluation of the Postoperative Analgesic Efficacy of Pericapsular Nerve Group (PENG) Block and Quadratus Lumborum Block (QLB) in Hip Surgeries
This prospective, randomized, single-blinded study compares the postoperative analgesic efficacy of the Pericapsular Nerve Group (PENG) block and Quadratus Lumborum Block (QLB) in hip surgeries under spinal anesthesia. the study focuses on time to first rescue analgesia and total analgesic consumption within the first 48 hours postoperatively in patients over 40 years undergoing elective hip surgery. Ninety patients will be randomized into two groups (PENG or QLB) using a sealed envelope method. The study will assess pain scores, opioid consumption, and side effects, hypothesizing that both blocks provide effective analgesia but seek to identify which offers superior efficacy. Statistical analysis will be performed with SPSS, aiming to contribute valuable insights into analgesic techniques for hip surgeries.
Read the detailed description
This is a prospective, randomized single-blinded study comparing the postoperative analgesic efficacy of Pericapsular Nerve Group (PENG) block and Quadratus Lumborum Block (QLB) in hip surgeries performed under spinal anesthesia. The study aims to evaluate key outcomes such as the time to first rescue analgesia and total analgesic consumption within the first 48 hours postoperatively. The primary population includes patients over 40 years undergoing elective hip surgery with specific inclusion and exclusion criteria. ninety patients will be divided into two groups, receiving either QLB or PENG block, using a sealed envelope randomization method.
PENG block targets specific nerves to provide analgesia without motor block, preserving motor function. QLB involves injecting a local anesthetic into the fascia near the quadratus lumborum muscle to block thoracoabdominal nerves and provide broad analgesia. Data on pain scores (NRS), opioid consumption, and side effects will be collected at different time points.
The study hypothesizes that both blocks can provide effective postoperative analgesia, with potential benefits such as reduced opioid consumption , but aims to determine which block is superior in efficacy.
The primary aim of this study was to compare the effect of an anterior QLB and PENG block on total opioid analgesic consumption within the first 48 hours postoperatively. The secondary aims were to compare the resting and dynamic NRS scores at 2, 12, 24 and 48 hours postoperatively, the time to first rescue analgesia, and side effects such as nausea, vomiting and quadriceps weakness.
Statistical analysis will be conducted using SPSS, and findings will contribute to the literature on analgesia techniques for hip surgeries.
- Conditions
- Hip Surgery, Postoperative Analgesia
- Being tested
- PENG block with 0.25% bupivacaine., anterior quadratus lumborum block
- Keywords
- PENG, QLB, Postoperative Analgesia, Hip Surgery
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PENG block with 0.25% bupivacaine.Procedure or surgery
In the PENG group, patients were placed in the supine position. A convex ultrasound probe was positioned under sterile conditions on the operated side, aligned with the iliac bone below the anterior superior iliac spine (ASIS). The anterior inferior iliac spine (AIIS), iliopubic eminence (IPE), iliopsoas muscle, and its tendon were identified. Using an in-plane technique, a 22G 100-mm peripheral block needle was advanced toward the IPE, targeting the space between the iliopsoas muscle tendon and the IPE. Proper placement was confirmed via hydrodissection. Subsequently, 20 mL of 0.25% bupivacaine was administered slowly, with aspiration performed every 5 mL to avoid intravascular injection. The correct spread of the local anesthetic was verified via ultrasound, confirming elevation of the iliopsoas tendon.
anterior quadratus lumborum blockProcedure or surgery
The quadratus lumborum and psoas major muscles, along with the transverse process of the L4 vertebra, were visualized in the midaxillary line using an in-plane technique. A 22G, 100-mm peripheral block needle (Stimuplex® Ultra; B. Braun Melsungen AG, Melsungen, Germany) was advanced into the subfascial plane between the quadratus lumborum and psoas major muscles, and 1-2 mL of 0.9% saline was injected to confirm correct placement via hydrodissection.
Following this, 20 mL of 0.25% bupivacaine (Buvasin® 0.5%, VEM, Tekirdağ, Turkey) was injected incrementally, with aspiration performed every 5 mL. Proper spread of the local anesthetic was confirmed by ultrasound visualization of a hypoechoic distribution between the fascial planes.
| Study group | Role | What they receive |
|---|---|---|
| QLB Group | Active comparator | In the QLB (Quadratus Lumborum Block) group, patients will be placed in the lateral decubitus position, and the block will be performed using ultrasound guidance Receives: Procedure: anterior quadratus lumborum block |
| PENG Block Group | Active comparator | In the PENG (Pericapsular Nerve Group) block group, patients will be positioned supine, and the block will be performed under ultrasound guidance. Receives: Procedure: PENG block with 0.25% bupivacaine. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total Opioid Consumption
Total Opioid Consumption
Measured: 48 hour
Secondary outcomes (3)
Numerical Rating Scale (NRS) Scores
Assessed at various time points to quantify pain intensity at rest and during movement. The Numerical Rating Scale (NRS) is a pain assessment tool where patients rate their pain from 0 (no pain) to 10 (worst pain).
Measured: 48 hour
Time to First Rescue Analgesic
Duration from the end of surgery to the first request for analgesic medication.
Measured: 48 hours
Adverse Events
Monitoring for complications or side effects related to the nerve blocks
Measured: 48 hour
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Oct 2024
- Study start25 Oct 2024
- Primary completion1 Apr 2025
- Study completion3 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Hip SurgeryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Care provider, Investigator, Outcomes assessor
- Enrolment
- 73 participants (actual)
Sponsor and investigators
- Lead sponsor
- Gaziosmanpasa Research and Education Hospital
- Sponsor type
- Other government
- Responsible party
- Principal investigator, SERPİL ŞEHİRLİOĞLU, Gaziosmanpasa Research and Education Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06653894
- Sponsor's protocol ID
- GaziosmanpasaTREH-PENG
- Acronym
- PENG vs QLB
- Status last verified
- May 2025
- First submitted
- 21 Oct 2024
- Last updated
- 7 Aug 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Stuart Green M, Ryan Hoffman C, Iqbal U, Olabisi Ives O, Hurd B. Transmuscular Quadratus Lumborum Block Reduces Length of Stay in Patients Receiving Total Hip Arthroplasty. Anesth Pain Med. 2018 Nov 20;8(6):e80233. doi: 10.5812/aapm.80233. eCollection 2018 Dec.
PubMed 30719411Farag A, Hendi NI, Diab RA. Does pericapsular nerve group block have limited analgesia at the initial post-operative period? Systematic review and meta-analysis. J Anesth. 2023 Feb;37(1):138-153. doi: 10.1007/s00540-022-03129-5. Epub 2022 Nov 7.
PubMed 36342537Zheng J, Pan D, Zheng B, Ruan X. Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebo-controlled trial. Reg Anesth Pain Med. 2022 Mar;47(3):155-160. doi: 10.1136/rapm-2021-103228. Epub 2021 Dec 6.
PubMed 34873023
Study at a glance
From the registry record, last updated by the sponsor on 7 Aug 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of the Postoperative Analgesic Efficacy of Pericapsular Nerve Group (PENG) Block and Quadratus Lumborum Block (QLB) in Hip Surgeries
- ClinicalTrials.gov ID
- NCT06653894
- Acronym / sponsor ID
- PENG vs QLB / GaziosmanpasaTREH-PENG
- Conditions
- Hip Surgery, Postoperative Analgesia
- Keywords
- PENG, QLB, Postoperative Analgesia, Hip Surgery
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 73 participants (actual)
- Lead sponsor
- Gaziosmanpasa Research and Education HospitalOther government
- Study start
- 25 Oct 2024 (actual)
- Primary completion
- 1 Apr 2025 (actual)
- Study completion
- 3 Apr 2025 (actual)
- First posted
- 22 Oct 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This prospective, randomized, single-blinded study compares the postoperative analgesic efficacy of the Pericapsular Nerve Group (PENG) block and Quadratus Lumborum Block (QLB) in hip surgeries under spinal anesthesia. the study focuses on time to first rescue analgesia and total analgesic consumption within the first 48 hours postoperatively in patients over 40 years undergoing elective hip surgery. Ninety patients will be randomized into two groups (PENG or QLB) using a sealed envelope method. The study will assess pain scores, opioid consumption, and side effects, hypothesizing that both blocks provide effective analgesia but seek to identify which offers superior efficacy. Statistical analysis will be performed with SPSS, aiming to contribute valuable insights into analgesic techniques for hip surgeries.
Detailed description
This is a prospective, randomized single-blinded study comparing the postoperative analgesic efficacy of Pericapsular Nerve Group (PENG) block and Quadratus Lumborum Block (QLB) in hip surgeries performed under spinal anesthesia. The study aims to evaluate key outcomes such as the time to first rescue analgesia and total analgesic consumption within the first 48 hours postoperatively. The primary population includes patients over 40 years undergoing elective hip surgery with specific inclusion and exclusion criteria. ninety patients will be divided into two groups, receiving either QLB or PENG block, using a sealed envelope randomization method.
PENG block targets specific nerves to provide analgesia without motor block, preserving motor function. QLB involves injecting a local anesthetic into the fascia near the quadratus lumborum muscle to block thoracoabdominal nerves and provide broad analgesia. Data on pain scores (NRS), opioid consumption, and side effects will be collected at different time points.
The study hypothesizes that both blocks can provide effective postoperative analgesia, with potential benefits such as reduced opioid consumption , but aims to determine which block is superior in efficacy.
The primary aim of this study was to compare the effect of an anterior QLB and PENG block on total opioid analgesic consumption within the first 48 hours postoperatively. The secondary aims were to compare the resting and dynamic NRS scores at 2, 12, 24 and 48 hours postoperatively, the time to first rescue analgesia, and side effects such as nausea, vomiting and quadriceps weakness.
Statistical analysis will be conducted using SPSS, and findings will contribute to the literature on analgesia techniques for hip surgeries.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| QLB Group | Active comparator | Procedure: anterior quadratus lumborum blockIn the QLB (Quadratus Lumborum Block) group, patients will be placed in the lateral decubitus position, and the block will be performed using ultrasound guidance |
| PENG Block Group | Active comparator | Procedure: PENG block with 0.25% bupivacaine.In the PENG (Pericapsular Nerve Group) block group, patients will be positioned supine, and the block will be performed under ultrasound guidance. |
Who may qualify
- Ages
- 40 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- "Patients aged over 40 years who are scheduled to undergo hip surgery under spinal anesthesia and classified as ASA 1-3 will be included in the study."
Key exclusion criteria (10 listed)
- Patients who refuse the procedure.
- Patients who will receive general anesthesia or peripheral nerve blocks such as a combination of femoral and sciatic nerve blocks.
- A history of allergy to local anesthetic agents.
- Patients with a diagnosis of neurocognitive disorders such as dementia or Alzheimer's disease under active neurological follow-up.
- Patients with multiple trauma.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PENG block with 0.25% bupivacaine.In the PENG group, patients were placed in the supine position. A convex ultrasound probe was positioned under sterile conditions on the operated side, aligned with the iliac bone below the anterior superior iliac spine (ASIS). The anterior inferior iliac spine (AIIS), iliopubic eminence (IPE), iliopsoas muscle, and its tendon were identified. Using an in-plane technique, a 22G 100-mm peripheral block needle was advanced toward the IPE, targeting the space between the iliopsoas muscle tendon and the IPE. Proper placement was confirmed via hydrodissection. Subsequently, 20 mL of 0.25% bupivacaine was administered slowly, with aspiration performed every 5 mL to avoid intravascular injection. The correct spread of the local anesthetic was verified via ultrasound, confirming elevation of the iliopsoas tendon. | Procedure or surgery | PENG Block Group |
| anterior quadratus lumborum blockThe quadratus lumborum and psoas major muscles, along with the transverse process of the L4 vertebra, were visualized in the midaxillary line using an in-plane technique. A 22G, 100-mm peripheral block needle (Stimuplex® Ultra; B. Braun Melsungen AG, Melsungen, Germany) was advanced into the subfascial plane between the quadratus lumborum and psoas major muscles, and 1-2 mL of 0.9% saline was injected to confirm correct placement via hydrodissection. Following this, 20 mL of 0.25% bupivacaine (Buvasin® 0.5%, VEM, Tekirdağ, Turkey) was injected incrementally, with aspiration performed every 5 mL. Proper spread of the local anesthetic was confirmed by ultrasound visualization of a hypoechoic distribution between the fascial planes. | Procedure or surgery | QLB Group |
Primary outcome
Total Opioid Consumption
Time frame: 48 hour
Total Opioid Consumption
3 secondary outcomes
Numerical Rating Scale (NRS) Scores
Time frame: 48 hour
Time to First Rescue Analgesic
Time frame: 48 hours
Adverse Events
Time frame: 48 hour
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Aug 2025.
- Results publication: PubMed 30719411Stuart Green M, Ryan Hoffman C, Iqbal U, Olabisi Ives O, Hurd B. Transmuscular Quadratus Lumborum Block Reduces Length of Stay in Patients Receiving Total Hip Arthroplasty. Anesth Pain Med. 2018 Nov 20;8(6):e80233. doi: 10.5812/aapm.80233. eCollection 2018 Dec.
- Results publication: PubMed 36342537Farag A, Hendi NI, Diab RA. Does pericapsular nerve group block have limited analgesia at the initial post-operative period? Systematic review and meta-analysis. J Anesth. 2023 Feb;37(1):138-153. doi: 10.1007/s00540-022-03129-5. Epub 2022 Nov 7.
- Results publication: PubMed 34873023Zheng J, Pan D, Zheng B, Ruan X. Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebo-controlled trial. Reg Anesth Pain Med. 2022 Mar;47(3):155-160. doi: 10.1136/rapm-2021-103228. Epub 2021 Dec 6.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing PENG block with 0.25% bupivacaine. and anterior quadratus lumborum block in people with Hip Surgery and Postoperative Analgesia, run by Gaziosmanpasa Research and Education Hospital at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Total Opioid Consumption (time frame: 48 hour). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06653894, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2025; AzTrials last refreshed its copy on 7 Nov 2026.