PENG Block Variants With Dexamethasone and Dexmedetomidine in Older Adults

NCT07327931 · tracked via the Priya Life Science Poland tracker

Sponsor

Poznan University of Medical Sciences

Phase

Not applicable

Started

2026-02-13

Last updated

2026-05-22

Condition(s) studied

Hip OsteoarthritisHip Pain Chronic

Investigational drug(s) / intervention(s)

Dexamethasone (intravenous) →Dexamethasone (intravenous) with Dexmedetomidine (perineural)Dexamethasone (perineural) with Dexmedetomidine (perineural)

Dexamethasone (intravenous): Perineural: 20 mL 0.2% ropivacaine + perineural placebo (normal saline) Intravenous: 4 mg dexamethasone + matching volume of saline if needed

Dexamethasone (intravenous) with Dexmedetomidine (perineural): Perineural: 20 mL 0.2% ropivacaine + 25 µg dexmedetomidine (± saline to equalize volume) Intravenous: 4 mg dexamethasone

Dexamethasone (perineural) with Dexmedetomidine (perineural): Perineural: 20 mL 0.2% ropivacaine + 25 µg dexmedetomidine + 4 mg dexamethasone Intravenous: placebo (0.9% normal saline)

Study summary

This study will compare three different versions of the Pericapsular Nerve Group (PENG) block in adults aged 65 years and older who are undergoing surgery for hip conditions. The PENG block is a regional anesthesia technique that can reduce pain after surgery and decrease the need for strong opioid pain medications.

All patients in the study will receive the PENG block with 20 mL of 0.2% ropivacaine, but they will be divided into three groups based on the additional medications used:

Group 1: PENG block with ropivacaine plus 4 mg of dexamethasone given intravenously.

Group 2: PENG block with ropivacaine plus 25 micrograms of dexmedetomidine given near the nerves and 4 mg of dexamethasone given intravenously.

Group 3: PENG block with ropivacaine plus 25 micrograms of dexmedetomidine and 4 mg of dexamethasone given near the nerves.

Both dexmedetomidine and dexamethasone are medications that may improve the strength and duration of nerve blocks.

The main goal of this study is to determine which combination provides the best pain control after hip surgery, reduces the need for opioid medications, and improves patient comfort and recovery. We also aim to evaluate the safety and side-effects of each technique.

We hypothesize that adding both dexmedetomidine and dexamethasone near the nerves will provide the longest and most effective pain relief when compared to intravenous administration alone.

This trial may help identify the most effective PENG block formula for older adults undergoing hip surgery and could improve pain management, decrease complications related to opioids, and support faster recovery.

Eligibility

Sex

ALL

Min age

65 Years

Max age

100 Years

Healthy volunteers

Inclusion Criteria: * Age 65 years or older * Scheduled for elective or emergency hip surgery (e.g., hip fracture fixation or hip arthroplasty) * ASA physical status I-III * Ability to communicate pain intensity using the NRS scale * Written informed consent obtained from the patient or legal representative * Planned use of PENG block as part of multimodal perioperative analgesia Exclusion Criteria: * Patient refusal or inability to provide informed consent * Allergy, intolerance, or contraindication to any study medication: ropivacaine, dexamethasone, dexmedetomidine * Pre-existing neurological deficit or neuropathy of the affected limb * Coagulopathy (INR \>1.5, platelets \<100,000/µL) or current therapeutic anticoagulation that contraindicates regional anesthesia * Infection at or near the injection site * Severe hepatic or renal impairment * History of chronic opioid use (daily opioids \>30 days before surgery) * Cognitive impairment or delirium precluding reliable pain assessment * BMI \> 40 kg/m² (if you want to exclude for technical difficulty) * Patients receiving another regional nerve block for hip surgery * Pregnancy or breastfeeding * Participation in another interventional clinical trial within 30 days

Primary outcome measure(s)

Time to First Rescue Analgesia — Within 48 hours after the end of surgery
Time (in hours) from the end of the PENG block (completion of local anesthetic injection) to the first administration of rescue analgesia (opioid or non-opioid) given for pain intensity ≥4 on the 0-10 Numerical Rating Scale (NRS). Data will be collected from anesthesia records and postoperative medication charts.

Trial sites (1)

Facility	City	Region	Status
Poznan University of Medical Sciences	Poznan	Poland	Recruiting

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Other trials for the same condition

PENG Block With Dexmedetomidine in Older Adults Recruiting

Molecular Mechanisms Underlying Hip and Knee Osteoarthritis in Patients Undergoing Primary Elective Arthroplasty Recruiting

Intravenous Dexamethasone (0 vs 4 vs 8 mg) as an Adjunct to PENG Block for Postoperative Analgesia in Total Hip Arthroplasty: A Randomized Double-Blind Trial Recruiting

PENG vs L-ESPB With S-ESPB for Analgesia in Total Hip Arthroplasty Recruiting

Comparison of Spinal Anesthesia With Intrathecal Morphine Versus PENG Block With or Without Dexamethasone in Hip Arthroplasty Starting soon

Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT07327931 on ClinicalTrials.gov ↗ ← All trials in Poland