Comparing Three PENG Block Techniques Using Ropivacaine With Different Combinations of Dexamethasone and Dexmedetomidine for Pain Relief After Hip Surgery in Adults 65 and Older

What this Trial Is About

Researchers are comparing three different versions of the Pericapsular Nerve Group PENG block in adults aged 65 years and older undergoing hip surgery. The PENG block is a regional anesthesia technique aimed at reducing pain and decreasing the use of strong opioid medications after surgery. The study seeks to find the best combination of medications added to the PENG block to improve pain relief, patient comfort, and recovery while evaluating safety and side effects. All participants will receive a PENG block with 20 mL of 0.2% ropivacaine. They will be randomly assigned to one of three groups Group 1 receives ropivacaine plus 4 mg of dexamethasone intravenously Group 2 receives ropivacaine with 25 micrograms of dexmedetomidine near the nerves plus 4 mg of dexamethasone intravenously Group 3 receives ropivacaine with both 25 micrograms of dexmedetomidine and 4 mg of dexamethasone near the nerves. Some groups will receive placebos to keep the study blinded. Participants will be followed after surgery to assess pain levels using numerical rating scales at several intervals up to 48 hours, opioid use, side effects, nerve block duration, motor function, time to first rescue analgesia, and patient satisfaction. Safety will be monitored through recording adverse events and neurological complications. The study aims to identify the most effective PENG block variant to improve pain management and support faster recovery after hip surgery in older adults.

PENG Block Variants With Dexamethasone and Dexmedetomidine in Older Adults