Comparison of Pericapsular Nerve Group (PENG) Block Versus Lumbar Erector Spinae Plane Block (L-ESPB) Combined With Sacral ESPB (S-ESPB) for Analgesia in Total Hip Arthroplasty (THA): A Randomized Clinical Trial

What this Trial Is About

This research aims to compare two types of regional anesthesia to see which better controls pain and supports recovery after total hip replacement surgery in adults aged 65 and older. It focuses on whether the Pericapsular Nerve Group (PENG) block reduces opioid use more effectively than the combination of Lumbar and Sacral Erector Spinae Plane Blocks (L-ESPB + S-ESPB). The study also evaluates which method offers better pain relief, preserves muscle strength, and helps patients walk sooner after surgery. Participants will be randomly assigned to one of two groups receiving ultrasound-guided nerve blocks along with standard spinal anesthesia and postoperative pain management. One group receives the PENG block plus a lateral femoral cutaneous nerve (LFCN) block with sham injections at lumbar and sacral sites. The other group receives lumbar and sacral ESP blocks with sham PENG and LFCN injections. All patients will have spinal anesthesia with ropivacaine during surgery. During the study, participants will be monitored for total opioid use over the first 48 hours after surgery, pain scores at multiple time points up to 48 hours, time to first walking, quadriceps muscle strength, satisfaction, and side effects. These measures will help determine which anesthesia approach provides better pain control and faster functional recovery following hip replacement. The study starts in September 2025 and continues until November 2026.

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