PENG With LFCB vs. ESP Blocks for Pediatric Hip Surgery

Phase 4

Recruiting

• Conditions: Hip Disease; Hip Dysplasia; Hip Arthropathy
• Interventions: Drug: Ropivacaine 0.2% for PENG Block; Drug: Ropivacaine 0.2% for L-ESPB; Drug: Ropivacaine 0.2% for LFCB; Drug: Ropivacaine 0.2% for S-ESPB

• Registration Number: NCT07023094
• Lead Sponsor: Poznan University of Medical Sciences

Brief Summary

This randomized controlled trial (RCT) compares the analgesic effectiveness of two regional anesthesia techniques-Pericapsular Nerve Group (PENG) block combined with Lateral Femoral Cutaneous Nerve Block (LFCB) versus Lumbar and Sacral Erector Spinae Plane Blocks (L-ESPB and S-ESPB)-in pediatric patients undergoing hip surgery.

Detailed Description

Orthopedic hip procedures in pediatric patients, including osteotomies, arthroscopic interventions, and reconstructive surgeries, often result in significant postoperative pain. Effective analgesia is critical for reducing surgical stress, accelerating rehabilitation, and minimizing opioid use and associated side effects. Regional anesthesia techniques have gained attention for their opioid-sparing effects and enhanced recovery profiles.

This randomized controlled trial aims to compare the analgesic effectiveness of two regional anesthetic approaches:

- The pericapsular nerve group (PENG) block is combined with the lateral fetal cutaneous nerve block (LFCB), targeting hip joint innervation directly and providing comprehensive sensory coverage.

Lumbar and sacral erector spinae plane blocks (L-ESPB and S-ESPB) employ fascial plane techniques to deliver analgesia by diffusing local anesthetic around nerves innervating the hip region.

This trial aims to establish the optimal regional anesthesia technique and determine the clinical benefits of using dexamethasone and dexmedetomidine as adjuvants. The results will guide clinicians toward evidence-based analgesic protocols in pediatric orthopedic hip surgery, potentially reducing opioid-related complications and improving patient recovery outcomes.

Study Timeline

• Status Verified: 2025-06
• Study First Submitted: 2025-06-08
• Study First Submitted QC: 2025-06-08
• Study First Posted: 2025-06-15
• Study Start: 2025-06-16
• Last Update Submitted: 2025-07-08
• Last Update Posted: 2025-07-11
• Primary Completion: 2026-05-30
• Study Completion: 2026-06-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Pediatric patients aged between 2 and 16 years.
• Scheduled for elective orthopedic hip surgery, including: Osteotomies and Hip reconstruction surgeries
• ASA (American Society of Anesthesiologists) physical status classification: I-III.
• Written informed consent obtained from the patient's legal guardian(s).

Exclusion Criteria

• Known allergy or hypersensitivity to any of the study medications
• Presence of infection or inflammation at the intended injection site(s) of regional anesthesia.
• Coagulopathy or bleeding disorders (including patients on anticoagulant therapy) that contraindicate nerve blocks.
• Neurological disorders or peripheral neuropathies that could influence sensory or motor assessment of the lower limbs.
• Cognitive impairment or behavioral disorders significantly affecting pain assessment accuracy or cooperation.
• History of chronic opioid use or known substance abuse.
• Severe systemic disease or condition compromising patient safety or interfering with study protocol adherence.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
PENG + LFCB	Ropivacaine 0.2% for PENG Block	U-S guided PENG block - 0.4ml/kg 0.2% ropivacaine + U-S guided LFCB - 0.1ml/kg 0.2% ropivacaine
PENG + LFCB	Ropivacaine 0.2% for LFCB	U-S guided PENG block - 0.4ml/kg 0.2% ropivacaine + U-S guided LFCB - 0.1ml/kg 0.2% ropivacaine
L-ESPB + S-ESPB	Ropivacaine 0.2% for L-ESPB	U-S guided L-ESPB - 0.25ml/kg 0.2% ropivacaine + U-S guided S-ESPB - 0.25ml/kg 0.2% ropivacaine
L-ESPB + S-ESPB	Ropivacaine 0.2% for S-ESPB	U-S guided L-ESPB - 0.25ml/kg 0.2% ropivacaine + U-S guided S-ESPB - 0.25ml/kg 0.2% ropivacaine

Primary Outcome Measures

Name	Time	Method
Total Opioid Consumption	48 hours after surgery	Total opiate consumption after surgery

Secondary Outcome Measures

Name	Time	Method
PLR	48 hours after surgery	platelet to lymphocyte ratio
Time to first rescue opioid analgesia	48 hours after surgery	Time after surgery when the patient needs opiate for the first time
Numerical Rating Scale [range 0:10]	48 hours after surgery	Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt)
NLR	48 hours after surgery	neutrophile to lymphocyte ratio

Trial Locations

Locations (1)

Poznan University of Medical Sciences; 🇵🇱 Poznań, Poland