Three Variants of the PENG Block With and Without Perineural Adjuvants in Older Adults

NCT07330999 · 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 Osteoarthritis

Investigational drug(s) / intervention(s)

Ropivacaine 0.2% Injectable Solution →Dexamethasone 4mg →Dexmedetomidine →

Ropivacaine 0.2% Injectable Solution: 20 mL of 0.2% ropivacaine administered perineurally as part of the PENG block. No perineural or intravenous adjuvant drugs will be used in this arm.

Dexamethasone 4mg: 4 mg of dexamethasone administered perineurally together with 20 mL of 0.2% ropivacaine for the PENG block. No intravenous dexamethasone will be administered.

Dexmedetomidine: 25 micrograms of dexmedetomidine administered perineurally together with 20 mL of 0.2% ropivacaine for the PENG block. No intravenous dexamethasone will be administered.

Study summary

This study will compare three versions of the Pericapsular Nerve Group (PENG) block in adults aged 65 years and older who are undergoing hip surgery. The PENG block is a regional anesthesia technique used to reduce pain around the hip joint and may improve early recovery after surgery.

All patients in the study will receive the PENG block using 20 mL of 0.2% ropivacaine. They will then be randomly assigned to one of three groups:

Group 1: PENG block using ropivacaine only (no additional medications). Group 2: PENG block using ropivacaine with 4 mg of dexamethasone injected near the nerves.

Group 3: PENG block using ropivacaine with 25 micrograms of dexmedetomidine injected near the nerves.

Dexamethasone and dexmedetomidine are medications that may increase the duration and quality of regional anesthesia. It is not known whether adding one of these medications provides longer-lasting or better pain relief compared to using ropivacaine alone.

The main purpose of this study is to determine whether the addition of dexamethasone or dexmedetomidine improves the effectiveness of the PENG block in relieving pain after hip surgery. The study will evaluate pain levels, opioid consumption, time to first rescue pain medication, need for additional analgesia, and recovery outcomes. Safety, side effects, and any block-related complications will also be monitored.

The investigators hypothesize that adding either perineural dexamethasone or dexmedetomidine will result in longer and more effective pain relief compared with the standard PENG block without an adjuvant.

This research may help identify the most effective form of the PENG block for older adults undergoing hip surgery and contribute to improved pain management, reduced opioid use, and better postoperative 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 * Planned use of a PENG block as part of perioperative analgesia * Ability to communicate pain intensity using the NRS scale * Written informed consent obtained from the patient or legal representative Exclusion Criteria: * Refusal or inability to provide informed consent * Known allergy, intolerance, or contraindication to any of the study medications: ropivacaine, dexamethasone, dexmedetomidine * Pre-existing neurological deficit or neuropathy in the affected limb * Coagulopathy or laboratory abnormality that contraindicates regional anesthesia: INR \>1.5, or platelet count \<100,000/µL, or therapeutic anticoagulation that cannot be safely paused * Infection at or near the needle insertion site * Severe hepatic or renal impairment * Chronic opioid therapy (\>30 days of daily opioids before surgery) * Cognitive impairment or delirium that prevents reliable pain assessment * BMI \>40 kg/m² (due to potential technical difficulty and reduced accuracy of ultrasound guidance) * Previous regional block affecting the target area for the current 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 surgery.
Time (in hours) from completion of the PENG block to the first administration of a rescue analgesic (opioid or non-opioid) given for pain intensity ≥4 on the 0-10 Numerical Rating Scale (NRS).

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

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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

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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 NCT07330999 on ClinicalTrials.gov ↗ ← All trials in Poland