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Low-Volume Pericapsular Nerve Group (PENG) Block With Dexamethasone vs Standard-Volume PENG Block After Total Hip Arthroplasty

RecruitingPhase 4Ages 50 Years - 70 YearsAllAin Shams University
NCT07855341 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

The goal of this clinical trial is to compare two regimens of the pericapsular nerve group (PENG) block, an ultrasound-guided injection of local anaesthetic targeting the nerves supplying the front of the hip joint, for postoperative pain relief and quadriceps muscle function in patients undergoing primary unilateral total hip arthroplasty under spinal anaesthesia. The PENG block was originally proposed as a motor-sparing technique. However, the standard 20 mL volume can spread to the femoral nerve and cause quadriceps weakness. Reducing the injected volume may limit this spread and better preserve quadriceps strength, but smaller volumes risk shorter analgesic duration. Adding dexamethasone to a low-volume injection may compensate for the reduced volume. The main questions this trial aims to answer are: * Does a low-volume PENG block (10 mL bupivacaine 0.25%) with 4 mg dexamethasone

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📋 Eligibility rules (as published)
Inclusion Criteria: * Physical status ASA I or II. * Age 50-70 years. * Patients scheduled for elective primary unilateral total hip arthroplasty under spinal anaesthesia. * No sex predilection. Exclusion Criteria: * Patient refusal. * Physical status ASA III or above. * Contraindications to spinal anaesthesia (coagulopathy, local infection at injection site, raised intracranial pressure). * Revision or bilateral total hip arthroplasty. * Known allergy or hypersensitivity to study drugs (bupivacaine, dexamethasone) or to any component of the multimodal analgesic regimen (paracetamol, nalbuphine). * Pre-existing neuromuscular disease, lower-limb motor deficit, or neuropathic pain syndrome. * Uncontrolled diabetes mellitus (HbA1c \> 8% or fasting blood glucose \> 180 mg/dL) or any contraindication to corticosteroids. * Cognitive impairment precluding pain and motor assessment, or chronic opioid use. * Body mass index greater than 40 kg/m2 precluding adequate ultrasound visualization.
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What it tests

  • Pericapsular nerve group (PENG) block
  • Bupivacaine
  • Dexamethasone
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Where

1 site
Ain Shams University Hospitals (El Demerdash Hospital)
Cairo, Egypt
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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