Pain ManagementQLESPNCT07771829
QLESP Block Versus PENG+LFCN Block for Total Hip Arthroplasty
A study testing QLESP Block, PENG+LFCN Block and ropivacaine in people with Pain Management and Arthroplasty Total Hip Replacement, run by Huazhong University of Science and Technology at 1 site in China.
Trial summary
Total hip arthroplasty (THA) is a common surgery to replace damaged hip joints, but many patients experience significant pain after surgery, which can delay recovery and increase the need for strong pain medications (opioids). Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Pain Management, Arthroplasty Total Hip Replacement
- What is being tested?
- QLESP Block, PENG+LFCN Block and ropivacaine
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 136 participants
- Where
- 1 siteChina
- Study dates
- 19 Aug 2026to 28 Feb 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 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18 to 70 years
- Scheduled for elective unilateral total hip arthroplasty via posterolateral approach
- American Society of Anesthesiologists (ASA) physical status I-III
- Body mass index (BMI) < 35 kg/m²
- Ability to understand pain scoring and patient-controlled analgesia (PCA) use
- Willing and able to provide written informed consent
Who cannot join
- Allergy or hypersensitivity to local anesthetics (ropivacaine)
- Long-term opioid use or chronic pain history requiring regular analgesic use
- Active malignancy or infection at the puncture site
- Severe psychiatric disorders or communication barriers
- Severe cardiopulmonary disease
- History of opioid abuse or substance dependence
Show all 10Show fewer
- Participation in another interventional clinical trial within 3 months prior to enrollment
- Coagulation abnormalities
- Pregnancy or breastfeeding
- Any condition that, in the investigator's opinion, would compromise patient safety or data integrity
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
China1 site, 1 recruiting
- Recruiting
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, 430022
You-nian Xu, Professor, +8613657263415, xyn0103@hust.edu.cn
About this study
Official title: Comparison of Ultrasound-Guided QLESP Block Versus Pericapsular Nerve Group Block Combined With Lateral Femoral Cutaneous Nerve Block on Postoperative Analgesia and Functional Recovery in Total Hip Arthroplasty: A Randomized Controlled Trial
Total hip arthroplasty (THA) is a common surgery to replace damaged hip joints, but many patients experience significant pain after surgery, which can delay recovery and increase the need for strong pain medications (opioids). Nerve blocks are a technique where anesthetic medication is injected near specific nerves to reduce pain. This study compares two different ultrasound-guided nerve block techniques for pain control after THA: the QLESP block (a newer technique that targets two areas with a single injection) and the PENG block combined with the LFCN block (a currently used technique that targets nerves around the hip joint and the outer thigh). Participants in this study will be randomly assigned (like a coin flip) to receive either the QLESP block or the PENG+LFCN block after surgery. The study aims to determine which nerve block provides better pain relief and reduces the need for opioid pain medications in the first 24 hours after surgery. Pain scores, recovery of leg movement, time to first walk, length of hospital stay, and any side effects will also be compared between the two groups.
Read the detailed description
Background: Total hip arthroplasty (THA) is a common orthopedic procedure, but postoperative pain remains a significant challenge that can delay recovery and increase opioid consumption. Regional nerve blocks are a key component of multimodal analgesia. The QLESP block is a novel single-puncture, dual-plane technique developed by our group, while the PENG+LFCN block is a currently used motor-sparing technique. However, no randomized controlled trial has directly compared these two approaches.
Objective: This study aims to compare the analgesic efficacy and functional recovery outcomes of QLESP block versus PENG+LFCN block in patients undergoing THA.
Design: This is a single-center, prospective, randomized, assessor-blinded, parallel-controlled trial. Participants will be randomly assigned in a 1:1 ratio to receive either QLESP block or PENG+LFCN block after surgery. All participants will receive standardized general anesthesia and postoperative multimodal analgesia.
Exploratory biomarker sub-study: An exploratory sub-study will analyze plasma proteomic profiles in a subset of participants to identify potential molecular mechanisms underlying differences in pain response. Blood samples will be collected at baseline and 24 hours postoperatively. This analysis is exploratory and hypothesis-generating.
Sample size: A total of 140 participants will be enrolled (70 per group). Follow-up: Participants will be followed for 48 hours after surgery.
- Being tested
- QLESP Block, PENG+LFCN Block, ropivacaine
- Keywords
- Total Hip Arthroplasty, Nerve Block, Postoperative Analgesia, QLESP Block, PENG Block
- Medical subject headings
- Agnosia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
QLESP BlockProcedure or surgery
Ultrasound-guided quadratus lumborum and modified erector spinae plane block. A single-puncture, dual-injection technique at the L4 level. Total volume: 30 mL of 0.375% ropivacaine.
PENG+LFCN BlockProcedure or surgery
Ultrasound-guided pericapsular nerve group block combined with lateral femoral cutaneous nerve block. PENG: 20 mL of 0.375% ropivacaine; LFCN: 10 mL of 0.375% ropivacaine.
ropivacaineDrug
Ropivacaine hydrochloride injection, 0.375% solution, administered as a single dose via ultrasound-guided nerve block. Total dose: 112.5 mg (30 mL of 0.375% solution) for the QLESP group; 112.5 mg (30 mL of 0.375% solution) for the PENG+LFCN group.
| Study group | Role | What they receive |
|---|---|---|
| QLESP Group | Experimental | Participants receive ultrasound-guided QLESP block with 30 mL of 0.375% ropivacaine (15 mL between the erector spinae and transverse process, and 15 mL between the quadratus lumborum and psoas major). Receives: Procedure: QLESP Block; Drug: ropivacaine |
| PENG+LFCN Group | Active comparator | Participants receive ultrasound-guided PENG block with 20 mL of 0.375% ropivacaine combined with LFCN block with 10 mL of 0.375% ropivacaine. Receives: Procedure: PENG+LFCN Block; Drug: ropivacaine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Postoperative 24-Hour Cumulative Opioid Consumption
Measured: At 24 hours after surgery
Secondary outcomes (7)
Postoperative VAS Pain Scores
The Visual Analogue Scale (VAS) is a 10-cm line ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate worse pain. Pain scores are assessed at rest and during movement (passive hip flexion to 15 degrees) at each time point.
Measured: At 6, 12, 24, 36, and 48 hours after surgery
Rescue Analgesia Requirement
Measured: Within 24 hours after surgery
Motor Block Assessment (Bromage Score)
The Bromage Score is a 4-point scale ranging from 0 (no motor block, able to perform full knee flexion and foot dorsiflexion against resistance) to 3 (complete motor block, unable to move knee or foot). Higher scores indicate worse motor function. Assessed on the operative side at each time point. A score of 0-1 is considered clinically acceptable for early ambulation.
Measured: At 6, 24, and 48 hours after surgery
Time to First Ambulation
Measured: From surgery end to first walk, up to 7 days
Length of Hospital Stay
Measured: From surgery date to discharge, up to 30 days
Incidence of Adverse Events
Measured: From surgery end to 48 hours after surgery
Change in Plasma Proteomic Profile from Baseline to 24 Hours Postoperatively
Measured: Baseline 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 posted18 Aug 2026
- Study start19 Aug 2026
- Primary completion15 Feb 2027 (estimated)
- Study completion28 Feb 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Pain ManagementStudies of the same condition, open and under way.
- More trials run by Huazhong University of Science and TechnologyThe sponsor's other registered studies.
- 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
- Participants are randomly assigned in a 1:1 ratio to receive either QLESP block or PENG combined with LFCN block
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 136 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Huazhong University of Science and Technology
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Xi Wu, Huazhong University of Science and Technology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07771829
- Sponsor's protocol ID
- WHUH20260809
- Acronym
- QLESP
- Status last verified
- Sep 2026
- First submitted
- 10 Aug 2026
- Last updated
- 29 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: The study protocol and informed consent form did not include provisions for secondary data analysis by external researchers.
Publications
Tian Y, Lu Q, Yuan Y, Hu Z, Li W, Li K. The effect of pericapsular nerve group block and lateral femoral cutaneous nerve block on postoperative recovery after hip arthroplasty. Sci Rep. 2025 Jun 6;15(1):19913. doi: 10.1038/s41598-025-04699-6.
PubMed 40481108Pascarella G, Costa F, Strumia A, Ruggiero A, Remore LM, Lanteri T, Hazboun A, Longo F, Gargano F, Schiavoni L, Mattei A, Agro FE, Carassiti M, Cataldo R. Lateral Femoral Cutaneous Nerve Block or Wound Infiltration Combined with Pericapsular Nerve Group (PENG) Block for Postoperative Analgesia following Total Hip Arthroplasty through Posterior Approach: A Randomized Controlled Trial. J Clin Med. 2024 May 2;13(9):2674. doi: 10.3390/jcm13092674.
PubMed 38731203Liang L, Zhang C, Dai W, He K. Comparison between pericapsular nerve group (PENG) block with lateral femoral cutaneous nerve block and supra-inguinal fascia iliaca compartment block (S-FICB) for total hip arthroplasty: a randomized controlled trial. J Anesth. 2023 Aug;37(4):503-510. doi: 10.1007/s00540-023-03192-6. Epub 2023 Apr 12.
PubMed 37043081Yang F, Tang Q, Wang B, Chen L. Pericapsular nerve group block combined with lateral femoral cutaneous nerve block for hip surgery: a meta-analysis. Front Pain Res (Lausanne). 2026 Jan 12;6:1723417. doi: 10.3389/fpain.2025.1723417. eCollection 2025.
PubMed 41601711Vetrone F, Marelli S, Galimberti A, Umbrello M, Gotti M, Pezzi A, Girombelli A. Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial. J Pers Med. 2025 Jun 3;15(6):230. doi: 10.3390/jpm15060230.
PubMed 40559093Hay E, Kelly T, Wolf BJ, Hansen E, Brown A, Lautenschlager C, Wilson SH. Comparison of pericapsular nerve group and lateral quadratus lumborum blocks on cumulative opioid consumption after primary total hip arthroplasty: a randomized controlled trial. Reg Anesth Pain Med. 2026 Jan 5;51(1):69-75. doi: 10.1136/rapm-2024-105875.
PubMed 39389587
Study at a glance
From the registry record, last updated by the sponsor on 29 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Ultrasound-Guided QLESP Block Versus Pericapsular Nerve Group Block Combined With Lateral Femoral Cutaneous Nerve Block on Postoperative Analgesia and Functional Recovery in Total Hip Arthroplasty: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07771829
- Acronym / sponsor ID
- QLESP / WHUH20260809
- Keywords
- Total Hip Arthroplasty, Nerve Block, Postoperative Analgesia, QLESP Block, PENG Block
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 136 participants (estimated)
- Lead sponsor
- Huazhong University of Science and TechnologyUniversity, hospital or other
- Study start
- 19 Aug 2026 (actual)
- Primary completion
- 15 Feb 2027 (estimated)
- Study completion
- 28 Feb 2027 (estimated)
- First posted
- 18 Aug 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.
Total hip arthroplasty (THA) is a common surgery to replace damaged hip joints, but many patients experience significant pain after surgery, which can delay recovery and increase the need for strong pain medications (opioids). Nerve blocks are a technique where anesthetic medication is injected near specific nerves to reduce pain. This study compares two different ultrasound-guided nerve block techniques for pain control after THA: the QLESP block (a newer technique that targets two areas with a single injection) and the PENG block combined with the LFCN block (a currently used technique that targets nerves around the hip joint and the outer thigh). Participants in this study will be randomly assigned (like a coin flip) to receive either the QLESP block or the PENG+LFCN block after surgery. The study aims to determine which nerve block provides better pain relief and reduces the need for opioid pain medications in the first 24 hours after surgery. Pain scores, recovery of leg movement, time to first walk, length of hospital stay, and any side effects will also be compared between the two groups.
Detailed description
Background: Total hip arthroplasty (THA) is a common orthopedic procedure, but postoperative pain remains a significant challenge that can delay recovery and increase opioid consumption. Regional nerve blocks are a key component of multimodal analgesia. The QLESP block is a novel single-puncture, dual-plane technique developed by our group, while the PENG+LFCN block is a currently used motor-sparing technique. However, no randomized controlled trial has directly compared these two approaches.
Objective: This study aims to compare the analgesic efficacy and functional recovery outcomes of QLESP block versus PENG+LFCN block in patients undergoing THA.
Design: This is a single-center, prospective, randomized, assessor-blinded, parallel-controlled trial. Participants will be randomly assigned in a 1:1 ratio to receive either QLESP block or PENG+LFCN block after surgery. All participants will receive standardized general anesthesia and postoperative multimodal analgesia.
Exploratory biomarker sub-study: An exploratory sub-study will analyze plasma proteomic profiles in a subset of participants to identify potential molecular mechanisms underlying differences in pain response. Blood samples will be collected at baseline and 24 hours postoperatively. This analysis is exploratory and hypothesis-generating.
Sample size: A total of 140 participants will be enrolled (70 per group). Follow-up: Participants will be followed for 48 hours after surgery.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Participants are randomly assigned in a 1:1 ratio to receive either QLESP block or PENG combined with LFCN block
| Arm | Type | Receives |
|---|---|---|
| QLESP Group | Experimental | Procedure: QLESP Block, Drug: ropivacaineParticipants receive ultrasound-guided QLESP block with 30 mL of 0.375% ropivacaine (15 mL between the erector spinae and transverse process, and 15 mL between the quadratus lumborum and psoas major). |
| PENG+LFCN Group | Active comparator | Procedure: PENG+LFCN Block, Drug: ropivacaineParticipants receive ultrasound-guided PENG block with 20 mL of 0.375% ropivacaine combined with LFCN block with 10 mL of 0.375% ropivacaine. |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Age 18 to 70 years
- Scheduled for elective unilateral total hip arthroplasty via posterolateral approach
- American Society of Anesthesiologists (ASA) physical status I-III
- Body mass index (BMI) < 35 kg/m²
- Ability to understand pain scoring and patient-controlled analgesia (PCA) use
Key exclusion criteria (10 listed)
- Allergy or hypersensitivity to local anesthetics (ropivacaine)
- Long-term opioid use or chronic pain history requiring regular analgesic use
- Active malignancy or infection at the puncture site
- Severe psychiatric disorders or communication barriers
- Severe cardiopulmonary disease
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 |
|---|---|---|
| QLESP BlockUltrasound-guided quadratus lumborum and modified erector spinae plane block. A single-puncture, dual-injection technique at the L4 level. Total volume: 30 mL of 0.375% ropivacaine. | Procedure or surgery | QLESP Group |
| PENG+LFCN BlockUltrasound-guided pericapsular nerve group block combined with lateral femoral cutaneous nerve block. PENG: 20 mL of 0.375% ropivacaine; LFCN: 10 mL of 0.375% ropivacaine. | Procedure or surgery | PENG+LFCN Group |
| ropivacaineRopivacaine hydrochloride injection, 0.375% solution, administered as a single dose via ultrasound-guided nerve block. Total dose: 112.5 mg (30 mL of 0.375% solution) for the QLESP group; 112.5 mg (30 mL of 0.375% solution) for the PENG+LFCN group. | Drug | PENG+LFCN Group, QLESP Group |
Primary outcome
Postoperative 24-Hour Cumulative Opioid Consumption
Time frame: At 24 hours after surgery
7 secondary outcomes
Postoperative VAS Pain Scores
Time frame: At 6, 12, 24, 36, and 48 hours after surgery
Rescue Analgesia Requirement
Time frame: Within 24 hours after surgery
Motor Block Assessment (Bromage Score)
Time frame: At 6, 24, and 48 hours after surgery
Time to First Ambulation
Time frame: From surgery end to first walk, up to 7 days
Length of Hospital Stay
Time frame: From surgery date to discharge, up to 30 days
Incidence of Adverse Events
Time frame: From surgery end to 48 hours after surgery
Change in Plasma Proteomic Profile from Baseline to 24 Hours Postoperatively
Time frame: Baseline 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 29 Sep 2026.
- Background: PubMed 40481108Tian Y, Lu Q, Yuan Y, Hu Z, Li W, Li K. The effect of pericapsular nerve group block and lateral femoral cutaneous nerve block on postoperative recovery after hip arthroplasty. Sci Rep. 2025 Jun 6;15(1):19913. doi: 10.1038/s41598-025-04699-6.
- Background: PubMed 38731203Pascarella G, Costa F, Strumia A, Ruggiero A, Remore LM, Lanteri T, Hazboun A, Longo F, Gargano F, Schiavoni L, Mattei A, Agro FE, Carassiti M, Cataldo R. Lateral Femoral Cutaneous Nerve Block or Wound Infiltration Combined with Pericapsular Nerve Group (PENG) Block for Postoperative Analgesia following Total Hip Arthroplasty through Posterior Approach: A Randomized Controlled Trial. J Clin Med. 2024 May 2;13(9):2674. doi: 10.3390/jcm13092674.
- Background: PubMed 37043081Liang L, Zhang C, Dai W, He K. Comparison between pericapsular nerve group (PENG) block with lateral femoral cutaneous nerve block and supra-inguinal fascia iliaca compartment block (S-FICB) for total hip arthroplasty: a randomized controlled trial. J Anesth. 2023 Aug;37(4):503-510. doi: 10.1007/s00540-023-03192-6. Epub 2023 Apr 12.
- Background: PubMed 41601711Yang F, Tang Q, Wang B, Chen L. Pericapsular nerve group block combined with lateral femoral cutaneous nerve block for hip surgery: a meta-analysis. Front Pain Res (Lausanne). 2026 Jan 12;6:1723417. doi: 10.3389/fpain.2025.1723417. eCollection 2025.
- Background: PubMed 40559093Vetrone F, Marelli S, Galimberti A, Umbrello M, Gotti M, Pezzi A, Girombelli A. Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial. J Pers Med. 2025 Jun 3;15(6):230. doi: 10.3390/jpm15060230.
- Background: PubMed 39389587Hay E, Kelly T, Wolf BJ, Hansen E, Brown A, Lautenschlager C, Wilson SH. Comparison of pericapsular nerve group and lateral quadratus lumborum blocks on cumulative opioid consumption after primary total hip arthroplasty: a randomized controlled trial. Reg Anesth Pain Med. 2026 Jan 5;51(1):69-75. doi: 10.1136/rapm-2024-105875.
- Individual participant dataSharing planned: No. The study protocol and informed consent form did not include provisions for secondary data analysis by external 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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing QLESP Block, PENG+LFCN Block and ropivacaine in people with Pain Management and Arthroplasty Total Hip Replacement, run by Huazhong University of Science and Technology at 1 site in China.
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 6 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: looking for participants now, as of the sponsor's last update on 29 Sep 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 China. 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 Xi Wu (+8615871715431, wu2018whuh@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Postoperative 24-Hour Cumulative Opioid Consumption (time frame: At 24 hours after surgery). 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 NCT07771829, which also lists 6 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 29 Sep 2026.