A Randomized Clinical Trial Evaluating Ultrasound-Guided Pericapsular Nerve Block (PENG) with Dexmedetomidine-Adjuvanted Ropivacaine Versus Plain Ropivacaine for Prolonged Pain Relief in Hip Surgery Patients

This prospective randomized controlled study includes 60 patients aged 18–75 years, belonging to ASA physical status I–III, scheduled for elective hip surgery. After institutional ethical committee approval and obtaining written informed consent, patients will be randomized using a computer-generated random table with concealed envelope technique into two groups: Group DR (n=30) receiving ultrasound-guided PENG block with 20 ml of 0.25% ropivacaine plus dexmedetomidine 0.5 µg/kg, and Group R (n=30) receiving 20 ml of 0.25% ropivacaine alone. All patients will be educated preoperatively regarding pain assessment using the Numeric Rating Scale and satisfaction using the Likert scale, and will undergo pre-anaesthetic evaluation a day prior to surgery. After standard fasting, patients will be monitored intraoperatively with ASA standard monitors, intravenous access will be secured, and Ringer lactate will be started at 10 ml/kg. Under aseptic precautions and ultrasound guidance, the PENG block will be performed preoperatively by injecting the assigned drug into the musculofascial plane between the psoas tendon and pubic ramus. Subsequently, all patients will receive subarachnoid block at L2–L5 interspace using a 25G Quincke needle with 0.5% hyperbaric bupivacaine at a dose of 0.3 mg/kg. Hemodynamic parameters including heart rate, systolic and diastolic blood pressure, and oxygen saturation will be recorded at baseline and perioperatively, and patients will be monitored and managed for complications such as hypotension, bradycardia, or local anesthetic systemic toxicity.