Total Hip Arthroplasty (THA)NCT06964282
Iliopsoas (IPB) and Pericapsular Nerve Group (PENG) Blocks Comparison on Analgesia and Recovery After Total Hip Arthroplasty
A study testing PENG Block and Iliopsoas nerve block in people with Total Hip Arthroplasty (THA) and Postoperative Pain Management, run by University of Liege at 1 site in Belgium.
Trial summary
Background: In recent years, regional anesthesia has become more popular because it can reduce pain and the need for strong pain medications like morphine. For hip surgery, the PENG block is already known to be effective. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Total Hip Arthroplasty (THA), Postoperative Pain Management, Peripheral Nerve Blocks
- What is being tested?
- PENG Block and Iliopsoas nerve block
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 118 participants
- Where
- 1 siteBelgium
- Study dates
- 1 Oct 2025to 10 Oct 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adult patients (age >18 years) ASA physical status classification I-III Scheduled for elective posterior approach total hip arthroplasty (THA) under spinal anesthesia
Who cannot join
- Pregnancy (confirmed by beta-HCG test if applicable) Known peripheral neuropathy or major neurological disease Chronic pain syndromes or long-term opioid use (>20 mg oral morphine equivalents/day) Severe hepatic or renal insufficiency Allergy to local anesthetics Major coagulopathies Vulnerable patients (e.g., minors, legally protected individuals)
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Belgium1 site, 1 recruiting
- Recruiting
Liege University Hospital
Liège, 4000
Michele Carella, MD, PhD, ESRA-DRA, +3242843658, mcarella@chuliege.be
About this study
Official title: Comparison Between Iliopsoas Block (IPB) and Pericapsular Nerve Group (PENG) Block on Postoperative Analgesia and Functional Recovery After Total Hip Arthroplasty Surgery: a Double-blinded Randomized Clinical Trial
Background:
In recent years, regional anesthesia has become more popular because it can reduce pain and the need for strong pain medications like morphine. For hip surgery, the PENG block is already known to be effective. A newer method, called the iliopsoas plane block (IPB), is very similar and has also shown good results in hip arthroscopy. However, these two techniques have never been directly compared in patients undergoing hip replacement surgery using the posterior approach.
Read more
Goal:
This study aims to see if the IPB is just as effective as the PENG block for controlling pain and helping patients recover well after hip replacement surgery.
Method:
118 adult patients scheduled for hip replacement under spinal anesthesia will be randomly assigned to receive either: IPB: 7 ml of Ropivacaine 7.5 mg/ml PENG: 14 ml of Ropivacaine 3.75 mg/ml Both injections are given under ultrasound guidance 30 minutes before spinal anesthesia. Neither the patient, the surgeon, nor the data collector will know which technique was used.
Post-Surgery Care:
All patients will receive standard pain relief, including:
Paracetamol every 6 hours Etoricoxib once a day Morphine via a patient-controlled pump for 48 hours
Main Outcome Measured:
The primary goal is to compare pain during movement 6 hours after surgery, using a pain scale from 0 (no pain) to 10 (worst pain). The study will consider the two blocks equivalent if the difference in average pain scores is less than 1 point.
Other Outcomes:
Total morphine used in 48 hours Pain scores at rest and during movement at various time points Walking ability (2- and 6-minute walk tests, and timed-up-and-go test) Quality of recovery (using the QoR-15 questionnaire) Side effects of morphine Patient satisfaction Length of hospital stay
Safety:
Both techniques are safe and already used in clinical practice. Ultrasound guidance minimizes risks like nerve injury, bleeding, or infection.
Conclusion:
If the IPB is shown to be as effective as the PENG block, both can be considered reliable options for pain control and early recovery after hip replacement surgery.
Read the detailed description
This study investigates the comparative effectiveness of two regional anesthesia techniques-the Pericapsular Nerve Group (PENG) block and the Iliopsoas Plane Block (IPB)-in patients undergoing total hip arthroplasty (THA) via the posterior surgical approach. While both blocks have shown promise in managing postoperative pain and minimizing opioid use, direct comparisons between them in this surgical context are lacking.
The PENG block, which targets the articular branches of the femoral, obturator, and accessory obturator nerves, has become increasingly used in anterior and lateral hip surgeries. The IPB, though more recently introduced, involves injection in a similar anatomical region and has shown good analgesic results in patients undergoing hip arthroscopy. Given their overlapping targets, these two blocks may offer comparable clinical benefits; however, this has not been validated in THA performed through a posterior approach.
To address this gap, the current randomized, double-blind equivalence trial will compare the two techniques using standardized ultrasound-guided procedures and uniform dosing of ropivacaine adjusted for volume and concentration. All patients will receive the same spinal anesthetic and postoperative analgesia regimen, minimizing confounding factors.
The primary objective is to determine whether IPB provides pain control equivalent to the PENG block during early postoperative mobilization. By assessing patient-reported pain scores, along with recovery quality and opioid use, the study aims to generate evidence that may inform anesthesia planning in joint replacement surgeries and support the integration of newer regional techniques into enhanced recovery protocols.
- Conditions
- Total Hip Arthroplasty (THA), Postoperative Pain Management, Peripheral Nerve Blocks, PENG Block, Iliopsoas Nerve Block
- Being tested
- PENG Block, Iliopsoas nerve block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PENG BlockProcedure or surgery
Also performed under ultrasound guidance with an 80 mm B-Braun X360 needle and a 3-5 MHz curved probe. The femoral nerve, femoral artery, iliopsoas muscle, and pubic ramus are identified. The needle is inserted in-plane, and 14 ml of ropivacaine 3.75 mg/ml is injected between the psoas tendon and pubic ramus.
Iliopsoas nerve blockProcedure or surgery
Performed under ultrasound guidance with a curvilinear probe (5-2 MHz). The transducer is positioned transversely below the anterior superior iliac spine (ASIS), then pivoted medially. After identifying the femoral head and acetabular rim, a 22G 80 mm needle is inserted in-plane to reach the iliopsoas plane, lateral to the iliopsoas tendon. 7 ml of ropivacaine 7.5 mg/ml is then injected.
| Study group | Role | What they receive |
|---|---|---|
| Group PENG | Active comparator | Patients will receive a pericapsular nerve group block with 14 ml of ropivacaine 3.75 mg/ml, administered 30 minutes prior to spinal anesthesia. Receives: Procedure: PENG Block |
| IPB Group | Active comparator | Patients will receive an iliopsoas plane block with 7 ml of ropivacaine 7.5 mg/ml, administered 30 minutes prior to spinal anesthesia. Receives: Procedure: Iliopsoas nerve block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Dynamic Pain 6h postoperative
Dynamic pain score (during mobilization) at 6 hours postoperatively, measured on a 0-10 numeric rating scale (NRS). Equivalence is defined as a mean difference of less than 1 point on the NRS.
Measured: 6 hours after surgery
Secondary outcomes (10)
Total Morphine Consumption
Total morphine consumption at 48 hours on Patient Controlled Intravenous Analgesia device.
Measured: First postoperative 48 hours
NRS Dynamic pain
NRS Dynamic pain score (at tight flexion) at 6 hours postoperatively, measured on a 0-10 numeric rating scale (NRS) and at 8 am, 1 pm, 6pm at postoperative day 1 and day 2. No pain: 0; Maximum pain: 10.
Measured: First postoperative 48 hours
NRS Rest pain
NRS Rest pain score (no mobilization) at 6 hours postoperatively, measured on a 0-10 numeric rating scale (NRS) and at 8 am, 1 pm, 6pm at postoperative day 1 and day 2. No pain: 0; Maximum pain: 10.
Measured: First postoperative 48 hours
2MWT
Distance walked in meters during 2-minute at postoperative day 1 and day 2
Measured: First postoperative 48 hours
6MWT
Distance walked in meters during 6-minutes test at postoperative day 1 and day 2
Measured: First postoperative 48 hours
TUG
Timed Up and Go (TUG) test results at postoperative day 1 and day 2
Measured: First postoperative 48 hours
QoR-15
Patient recovery scores using the 15-item Quality of Recovery (QoR-15) questionnaire on postoperative days 1 and 2. Minimum: 0; Maximum: 150.
Measured: First postoperative 48 hours
IPO
Patient satisfaction using the International Pain Outcomes (IPO) questionnaire at discharge. Each question is a 0 to 10 NRS scale with 0 minimum value and 10 maximum value.
Measured: 48 hours after surgery
Morphine-related complications
Incidence of opioid-related side effects (nausea, vomiting, constipation, urinary retention, pruritus, dizziness, hypotension)
Measured: First postoperative 48 hours
LOS
Length of hospital stay
Measured: 48 hours after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 May 2025
- Study start1 Oct 2025
- Primary completion1 Oct 2026 (estimated)
- Study completion10 Oct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Total Hip Arthroplasty (THA)Studies 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
- Model description
- Prospective, randomized, double-blind, controlled equivalence trial
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 118 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Liege
- Sponsor type
- University, hospital or other
- Collaborators
- Centre Hospitalier Universitaire de Liege
- Responsible party
- Principal investigator, Michele Carella, University of Liege
- Investigators
- Michele Carella, MD, PhD, ESRA-DRA, Principal investigator, Liège University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06964282
- Sponsor's protocol ID
- 2025-172
- Status last verified
- Apr 2026
- First submitted
- 30 Apr 2025
- Last updated
- 6 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Patient data will be anonymized and collected via the REDCap platform, compliant with current data protection regulations. Only the principal investigator and authorized study personnel will have access. Data will be stored securely for 10 years.
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison Between Iliopsoas Block (IPB) and Pericapsular Nerve Group (PENG) Block on Postoperative Analgesia and Functional Recovery After Total Hip Arthroplasty Surgery: a Double-blinded Randomized Clinical Trial
- ClinicalTrials.gov ID
- NCT06964282
- Acronym / sponsor ID
- 2025-172
- Conditions
- Total Hip Arthroplasty (THA), Postoperative Pain Management, Peripheral Nerve Blocks, PENG Block, Iliopsoas Nerve Block
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 118 participants (estimated)
- Lead sponsor
- University of LiegeUniversity, hospital or other
- Collaborators
- Centre Hospitalier Universitaire de Liege
- Study start
- 1 Oct 2025 (actual)
- Primary completion
- 1 Oct 2026 (estimated)
- Study completion
- 10 Oct 2026 (estimated)
- First posted
- 9 May 2025 (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.
Background:
In recent years, regional anesthesia has become more popular because it can reduce pain and the need for strong pain medications like morphine. For hip surgery, the PENG block is already known to be effective. A newer method, called the iliopsoas plane block (IPB), is very similar and has also shown good results in hip arthroscopy. However, these two techniques have never been directly compared in patients undergoing hip replacement surgery using the posterior approach.
Goal:
This study aims to see if the IPB is just as effective as the PENG block for controlling pain and helping patients recover well after hip replacement surgery.
Method:
118 adult patients scheduled for hip replacement under spinal anesthesia will be randomly assigned to receive either: IPB: 7 ml of Ropivacaine 7.5 mg/ml PENG: 14 ml of Ropivacaine 3.75 mg/ml Both injections are given under ultrasound guidance 30 minutes before spinal anesthesia. Neither the patient, the surgeon, nor the data collector will know which technique was used.
Post-Surgery Care:
All patients will receive standard pain relief, including:
Paracetamol every 6 hours Etoricoxib once a day Morphine via a patient-controlled pump for 48 hours
Main Outcome Measured:
The primary goal is to compare pain during movement 6 hours after surgery, using a pain scale from 0 (no pain) to 10 (worst pain). The study will consider the two blocks equivalent if the difference in average pain scores is less than 1 point.
Other Outcomes:
Total morphine used in 48 hours Pain scores at rest and during movement at various time points Walking ability (2- and 6-minute walk tests, and timed-up-and-go test) Quality of recovery (using the QoR-15 questionnaire) Side effects of morphine Patient satisfaction Length of hospital stay
Safety:
Both techniques are safe and already used in clinical practice. Ultrasound guidance minimizes risks like nerve injury, bleeding, or infection.
Conclusion:
If the IPB is shown to be as effective as the PENG block, both can be considered reliable options for pain control and early recovery after hip replacement surgery.
Detailed description
This study investigates the comparative effectiveness of two regional anesthesia techniques-the Pericapsular Nerve Group (PENG) block and the Iliopsoas Plane Block (IPB)-in patients undergoing total hip arthroplasty (THA) via the posterior surgical approach. While both blocks have shown promise in managing postoperative pain and minimizing opioid use, direct comparisons between them in this surgical context are lacking.
The PENG block, which targets the articular branches of the femoral, obturator, and accessory obturator nerves, has become increasingly used in anterior and lateral hip surgeries. The IPB, though more recently introduced, involves injection in a similar anatomical region and has shown good analgesic results in patients undergoing hip arthroscopy. Given their overlapping targets, these two blocks may offer comparable clinical benefits; however, this has not been validated in THA performed through a posterior approach.
To address this gap, the current randomized, double-blind equivalence trial will compare the two techniques using standardized ultrasound-guided procedures and uniform dosing of ropivacaine adjusted for volume and concentration. All patients will receive the same spinal anesthetic and postoperative analgesia regimen, minimizing confounding factors.
The primary objective is to determine whether IPB provides pain control equivalent to the PENG block during early postoperative mobilization. By assessing patient-reported pain scores, along with recovery quality and opioid use, the study aims to generate evidence that may inform anesthesia planning in joint replacement surgeries and support the integration of newer regional techniques into enhanced recovery protocols.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- Prospective, randomized, double-blind, controlled equivalence trial
| Arm | Type | Receives |
|---|---|---|
| Group PENG | Active comparator | Procedure: PENG BlockPatients will receive a pericapsular nerve group block with 14 ml of ropivacaine 3.75 mg/ml, administered 30 minutes prior to spinal anesthesia. |
| IPB Group | Active comparator | Procedure: Iliopsoas nerve blockPatients will receive an iliopsoas plane block with 7 ml of ropivacaine 7.5 mg/ml, administered 30 minutes prior to spinal anesthesia. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Adult patients (age >18 years) ASA physical status classification I-III Scheduled for elective posterior approach total hip arthroplasty (THA) under spinal anesthesia
Key exclusion criteria (1 listed)
- Pregnancy (confirmed by beta-HCG test if applicable) Known peripheral neuropathy or major neurological disease Chronic pain syndromes or long-term opioid use (>20 mg oral morphine equivalents/day) Severe hepatic or renal insufficiency Allergy to local anesthetics Major coagulopathies Vulnerable patients (e.g., minors, legally protected individuals)
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 BlockAlso performed under ultrasound guidance with an 80 mm B-Braun X360 needle and a 3-5 MHz curved probe. The femoral nerve, femoral artery, iliopsoas muscle, and pubic ramus are identified. The needle is inserted in-plane, and 14 ml of ropivacaine 3.75 mg/ml is injected between the psoas tendon and pubic ramus. | Procedure or surgery | Group PENG |
| Iliopsoas nerve blockPerformed under ultrasound guidance with a curvilinear probe (5-2 MHz). The transducer is positioned transversely below the anterior superior iliac spine (ASIS), then pivoted medially. After identifying the femoral head and acetabular rim, a 22G 80 mm needle is inserted in-plane to reach the iliopsoas plane, lateral to the iliopsoas tendon. 7 ml of ropivacaine 7.5 mg/ml is then injected. | Procedure or surgery | IPB Group |
Primary outcome
Dynamic Pain 6h postoperative
Time frame: 6 hours after surgery
Dynamic pain score (during mobilization) at 6 hours postoperatively, measured on a 0-10 numeric rating scale (NRS). Equivalence is defined as a mean difference of less than 1 point on the NRS.
10 secondary outcomes
Total Morphine Consumption
Time frame: First postoperative 48 hours
NRS Dynamic pain
Time frame: First postoperative 48 hours
NRS Rest pain
Time frame: First postoperative 48 hours
2MWT
Time frame: First postoperative 48 hours
6MWT
Time frame: First postoperative 48 hours
TUG
Time frame: First postoperative 48 hours
QoR-15
Time frame: First postoperative 48 hours
IPO
Time frame: 48 hours after surgery
Morphine-related complications
Time frame: First postoperative 48 hours
LOS
Time frame: 48 hours after surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 May 2026.
- Individual participant dataSharing planned: No. Patient data will be anonymized and collected via the REDCap platform, compliant with current data protection regulations. Only the principal investigator and authorized study personnel will have access. Data will be stored securely for 10 years.
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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.
Michele Carella, MD, PhD, ESRA-DRA principal investigator
Liège University Hospital
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 and Iliopsoas nerve block in people with Total Hip Arthroplasty (THA) and Postoperative Pain Management, run by University of Liege at 1 site in Belgium.
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 1 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: looking for participants now, as of the sponsor's last update on 6 May 2026. 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 Belgium. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Michele Carella, MD, PhD, ESRA-DRA (+3242843658, mcarella@chuliege.be), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Dynamic Pain 6h postoperative (time frame: 6 hours after surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 6 May 2026.