Postoperative PainNCT07502248
PENG Block With or Without PPD Block for Postoperative Analgesia After Total Hip Arthroplasty
A study testing PENG Block and Deep posterior gluteal compartment block in people with Postoperative Pain and Total Hip Arthroplasty (THA), run by Kirsehir Ahi Evran Universitesi.
Trial summary
This single-center, prospective, randomized controlled clinical trial aims to compare the postoperative analgesic efficacy of PENG block with or without posterior pericapsular deep gluteal block in adult patients undergoing elective primary total hip arthroplasty under spinal anesthesia. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Postoperative Pain, Total Hip Arthroplasty (THA)
- What is being tested?
- PENG Block and Deep posterior gluteal compartment block
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- No sites listed yet
- Study dates
- 5 Apr 2026to 5 Jun 2027
- 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
- Adults aged 18 years and older
- American Society of Anesthesiologists (ASA) physical status I-III
- Scheduled for elective primary total hip arthroplasty under spinal anesthesia
- Able to provide written informed consent
Who cannot join
- ASA physical status IV or V
- Serious concomitant cardiac, respiratory, hepatic, or renal disease
- Known neuropsychiatric disorder
- Cognitive impairment preventing understanding or response to the Numeric Rating Scale (NRS)
- Coagulopathy
- Local anesthetic allergy
Show all 13Show fewer
- Infection or scar at the block site
- Failed block
- Refusal to participate
- Signs of local anesthetic systemic toxicity after block
- Patients in the PENG plus PPD group who would be exposed to a total local anesthetic dose above 3 mg/kg in patients weighing less than 50 kg
- Revision total hip arthroplasty
- Total hip arthroplasty planned for fracture
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Comparison of the Efficacy of Pericapsular Nerve Group (PENG) Block Versus PENG Block Added to Posterior Pericapsular Deep Gluteal (PPD) Block for Postoperative Analgesia in Total Hip Arthroplasty
This single-center, prospective, randomized controlled clinical trial aims to compare the postoperative analgesic efficacy of PENG block with or without posterior pericapsular deep gluteal block in adult patients undergoing elective primary total hip arthroplasty under spinal anesthesia. Total hip arthroplasty is commonly associated with moderate to severe postoperative pain. Although PENG block provides analgesia for the anterior hip capsule, some patients may still experience pain originating from the posterior capsule. The addition of PPD block may improve analgesia by targeting posterior articular branches. Participants will be randomized into two groups: one group will receive PENG block, and the other group will receive PENG plus PPD block. Postoperative pain will be assessed using the Numeric Rating Scale (NRS). The study will compare postoperative pain scores and other analgesia-related outcomes between groups.
Read the detailed description
This study is planned as a single-center, prospective, randomized, controlled, double-blind trial in adult patients undergoing elective primary total hip arthroplasty under spinal anesthesia. Eligible participants will be patients aged 18 years or older, classified as ASA physical status I-III, and able to provide informed consent. Patients with ASA IV-V, serious cardiac, respiratory, hepatic, or renal disease, neuropsychiatric disorders, cognitive impairment preventing reliable NRS assessment, coagulopathy, local anesthetic allergy, infection or scar at the block site, failed block, signs of local anesthetic systemic toxicity, exposure to local anesthetic doses above protocol limits, revision total hip arthroplasty, fracture-related total hip arthroplasty, or refusal to participate will be excluded. Participants will be randomized by sealed-envelope method into two groups. Group 1 will receive PENG block after spinal anesthesia in the supine position using ultrasound guidance and 20 mL of 0.25% bupivacaine. Group 2 will receive PENG block followed by ultrasound-guided PPD block, with 30 mL of 0.25% bupivacaine used for the PPD block. In addition, both groups will receive lateral femoral cutaneous nerve block with 5 mL of 0.25% bupivacaine. The primary objective is to compare postoperative pain intensity between groups using Numeric Rating Scale scores. Secondary evaluations include postoperative analgesic consumption, time to first rescue analgesia, time to first mobilization, and motor function including ankle dorsiflexion strength. An initial pilot phase including 40 patients is planned, and the final sample size will be calculated using G*Power based on pilot data with alpha 0.05 and power 0.80. The study will continue until the target sample size is reached.
- Conditions
- Postoperative Pain, Total Hip Arthroplasty (THA)
- Being tested
- PENG Block, Deep posterior gluteal compartment block
- Keywords
- PENG block, PPD block, Postoperative analgesia, Numeric Rating Scale
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PENG BlockProcedure or surgery
Also called Pericapsular Nerve Group Block
Ultrasound-guided pericapsular nerve group block performed after spinal anesthesia for postoperative analgesia in patients undergoing primary total hip arthroplasty. In Group 1, PENG block will be performed in the supine position using an in-plane technique, and 20 mL of 0.25% bupivacaine will be injected between the psoas tendon and iliopubic ramus. In both groups, lateral femoral cutaneous nerve block will also be performed as part of the analgesic protocol.
Deep posterior gluteal compartment blockProcedure or surgery
Also called PPD block
Ultrasound-guided posterior pericapsular deep gluteal block performed after PENG block and spinal anesthesia for postoperative analgesia in patients undergoing primary total hip arthroplasty. In Group 2, the block will be performed in the lateral decubitus position with the hip and knee flexed to 90 degrees, and 30 mL of 0.25% bupivacaine will be injected after needle placement to the posterior acetabular rim near the ischiofemoral ligament using an in-plane technique.
| Study group | Role | What they receive |
|---|---|---|
| PENG Block | Active comparator | Participants in this arm will receive ultrasound-guided PENG block after spinal anesthesia for postoperative analgesia during primary total hip arthroplasty. In addition, lateral femoral cutaneous nerve block will be performed. Receives: Procedure: PENG Block |
| PENG Plus PPD Block | Active comparator | Participants in this arm will receive ultrasound-guided PENG block followed by ultrasound-guided posterior pericapsular deep gluteal block after spinal anesthesia for postoperative analgesia during primary total hip arthroplasty. In addition, lateral femoral cutaneous nerve block will be performed. Receives: Procedure: PENG Block; Procedure: Deep posterior gluteal compartment block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Postoperative pain intensity at 6 hours measured by Numeric Rating Scale (NRS)
Postoperative pain intensity will be assessed using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. The primary comparison between groups will be the NRS score at postoperative 6 hours
Measured: 6 hours after surgery
Secondary outcomes (5)
Postoperative pain intensity over the first 24 hours measured by Numeric Rating Scale (NRS)
Postoperative pain intensity will also be assessed in the recovery room and at postoperative 2, 12, and 24 hours using the Numeric Rating Scale (NRS)
Measured: Recovery room, 2 hours, 12 hours, and 24 hours after surgery
Total analgesic consumption during the first 24 hours
Total amount of analgesic medication consumed within the first 24 hours after surgery will be recorded and compared between groups
Measured: 24 hours after surgery
Time to first rescue analgesic requirement
Time from block performance to first additional analgesic requirement will be recorded
Measured: Up to 24 hours after surgery
Time to first mobilization
Time to first standing or mobilization after surgery will be recorded and compared between groups
Measured: Up to 24 hours after surgery
Ankle dorsiflexion motor strength
Ankle dorsiflexion motor strength will be assessed postoperatively to evaluate possible motor weakness related to block spread.
Measured: Recovery room, 2 hours, 6 hours, 12 hours, and 24 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 posted30 Mar 2026
- Study start5 Apr 2026 (estimated)
- Primary completion5 Apr 2027 (estimated)
- Study completion5 Jun 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Postoperative PainStudies 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
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Kirsehir Ahi Evran Universitesi
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Guzin Ceran, Kirsehir Ahi Evran Universitesi
- Investigators
- Guzin Ceran, MD, Principal investigator, Kirsehir Ahi Evran University Faculty of Medicine, Kirsehir Training and Research Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07502248
- Sponsor's protocol ID
- KAEAH-THA-PENG-PPD-01
- Status last verified
- Mar 2026
- First submitted
- 25 Mar 2026
- Last updated
- 30 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: There is no plan to share individual participant data with other researchers
Study at a glance
From the registry record, last updated by the sponsor on 30 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Efficacy of Pericapsular Nerve Group (PENG) Block Versus PENG Block Added to Posterior Pericapsular Deep Gluteal (PPD) Block for Postoperative Analgesia in Total Hip Arthroplasty
- ClinicalTrials.gov ID
- NCT07502248
- Acronym / sponsor ID
- KAEAH-THA-PENG-PPD-01
- Conditions
- Postoperative Pain, Total Hip Arthroplasty (THA)
- Keywords
- PENG block, PPD block, Postoperative analgesia, Numeric Rating Scale
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Kirsehir Ahi Evran UniversitesiUniversity, hospital or other
- Study start
- 5 Apr 2026 (estimated)
- Primary completion
- 5 Apr 2027 (estimated)
- Study completion
- 5 Jun 2027 (estimated)
- First posted
- 30 Mar 2026 (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 single-center, prospective, randomized controlled clinical trial aims to compare the postoperative analgesic efficacy of PENG block with or without posterior pericapsular deep gluteal block in adult patients undergoing elective primary total hip arthroplasty under spinal anesthesia. Total hip arthroplasty is commonly associated with moderate to severe postoperative pain. Although PENG block provides analgesia for the anterior hip capsule, some patients may still experience pain originating from the posterior capsule. The addition of PPD block may improve analgesia by targeting posterior articular branches. Participants will be randomized into two groups: one group will receive PENG block, and the other group will receive PENG plus PPD block. Postoperative pain will be assessed using the Numeric Rating Scale (NRS). The study will compare postoperative pain scores and other analgesia-related outcomes between groups.
Detailed description
This study is planned as a single-center, prospective, randomized, controlled, double-blind trial in adult patients undergoing elective primary total hip arthroplasty under spinal anesthesia. Eligible participants will be patients aged 18 years or older, classified as ASA physical status I-III, and able to provide informed consent. Patients with ASA IV-V, serious cardiac, respiratory, hepatic, or renal disease, neuropsychiatric disorders, cognitive impairment preventing reliable NRS assessment, coagulopathy, local anesthetic allergy, infection or scar at the block site, failed block, signs of local anesthetic systemic toxicity, exposure to local anesthetic doses above protocol limits, revision total hip arthroplasty, fracture-related total hip arthroplasty, or refusal to participate will be excluded. Participants will be randomized by sealed-envelope method into two groups. Group 1 will receive PENG block after spinal anesthesia in the supine position using ultrasound guidance and 20 mL of 0.25% bupivacaine. Group 2 will receive PENG block followed by ultrasound-guided PPD block, with 30 mL of 0.25% bupivacaine used for the PPD block. In addition, both groups will receive lateral femoral cutaneous nerve block with 5 mL of 0.25% bupivacaine. The primary objective is to compare postoperative pain intensity between groups using Numeric Rating Scale scores. Secondary evaluations include postoperative analgesic consumption, time to first rescue analgesia, time to first mobilization, and motor function including ankle dorsiflexion strength. An initial pilot phase including 40 patients is planned, and the final sample size will be calculated using G*Power based on pilot data with alpha 0.05 and power 0.80. The study will continue until the target sample size is reached.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| PENG Block | Active comparator | Procedure: PENG BlockParticipants in this arm will receive ultrasound-guided PENG block after spinal anesthesia for postoperative analgesia during primary total hip arthroplasty. In addition, lateral femoral cutaneous nerve block will be performed. |
| PENG Plus PPD Block | Active comparator | Procedure: PENG Block, Procedure: Deep posterior gluteal compartment blockParticipants in this arm will receive ultrasound-guided PENG block followed by ultrasound-guided posterior pericapsular deep gluteal block after spinal anesthesia for postoperative analgesia during primary total hip arthroplasty. In addition, lateral femoral cutaneous nerve block will be performed. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Adults aged 18 years and older
- American Society of Anesthesiologists (ASA) physical status I-III
- Scheduled for elective primary total hip arthroplasty under spinal anesthesia
- Able to provide written informed consent
Key exclusion criteria (13 listed)
- ASA physical status IV or V
- Serious concomitant cardiac, respiratory, hepatic, or renal disease
- Known neuropsychiatric disorder
- Cognitive impairment preventing understanding or response to the Numeric Rating Scale (NRS)
- Coagulopathy
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: Pericapsular Nerve Group BlockUltrasound-guided pericapsular nerve group block performed after spinal anesthesia for postoperative analgesia in patients undergoing primary total hip arthroplasty. In Group 1, PENG block will be performed in the supine position using an in-plane technique, and 20 mL of 0.25% bupivacaine will be injected between the psoas tendon and iliopubic ramus. In both groups, lateral femoral cutaneous nerve block will also be performed as part of the analgesic protocol. | Procedure or surgery | PENG Block, PENG Plus PPD Block |
| Deep posterior gluteal compartment blockAlso: PPD blockUltrasound-guided posterior pericapsular deep gluteal block performed after PENG block and spinal anesthesia for postoperative analgesia in patients undergoing primary total hip arthroplasty. In Group 2, the block will be performed in the lateral decubitus position with the hip and knee flexed to 90 degrees, and 30 mL of 0.25% bupivacaine will be injected after needle placement to the posterior acetabular rim near the ischiofemoral ligament using an in-plane technique. | Procedure or surgery | PENG Plus PPD Block |
Primary outcome
Postoperative pain intensity at 6 hours measured by Numeric Rating Scale (NRS)
Time frame: 6 hours after surgery
Postoperative pain intensity will be assessed using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. The primary comparison between groups will be the NRS score at postoperative 6 hours
5 secondary outcomes
Postoperative pain intensity over the first 24 hours measured by Numeric Rating Scale (NRS)
Time frame: Recovery room, 2 hours, 12 hours, and 24 hours after surgery
Total analgesic consumption during the first 24 hours
Time frame: 24 hours after surgery
Time to first rescue analgesic requirement
Time frame: Up to 24 hours after surgery
Time to first mobilization
Time frame: Up to 24 hours after surgery
Ankle dorsiflexion motor strength
Time frame: Recovery room, 2 hours, 6 hours, 12 hours, and 24 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 30 Mar 2026.
- Individual participant dataSharing planned: No. There is no plan to share individual participant data with other researchers
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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.
Guzin Ceran, MD principal investigator
Kirsehir Ahi Evran University Faculty of Medicine, Kirsehir Training and Research Hospital
Questions about this trial
What is this clinical trial studying?
A study testing PENG Block and Deep posterior gluteal compartment block in people with Postoperative Pain and Total Hip Arthroplasty (THA), run by Kirsehir Ahi Evran Universitesi.
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 4 inclusion and 13 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: opening soon, as of the sponsor's last update on 30 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
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 Guzin Ceran Assistant Professor, MD (+90-506-163-0936, gzncrn@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Postoperative pain intensity at 6 hours measured by Numeric Rating Scale (NRS) (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 30 Mar 2026.