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Lumbar Erector Spinae Plane Block Versus PENG Block for Hip Fracture Surgery
Sponsor: Beni-Suef University
Summary
The purpose of this clinical trial is to compare two different nerve block techniques-the Pericapsular Nerve Group (PENG) block and the Lumbar Erector Spinae Plane Block (L-ESPB)-for managing pain after hip fracture surgery in elderly patients. Hip fractures are common in older adults and often cause significant pain. Managing this pain effectively helps patients recover faster and move around sooner after surgery. Traditional pain relief options include nerve blocks and strong pain medications (opioids). However, opioids can cause unwanted side effects like nausea and drowsiness, while some traditional nerve blocks can weaken the leg muscles, making early walking difficult. Nerve blocks inject a local anesthetic (numbing medication) around specific nerves or within muscle layers to temporarily block pain signals: 1. PENG Block: Targets the specific sensory nerves supplying the front of the hip joint while minimizing leg muscle weakness. 2. Lumbar ESPB: Injects numbing medication near the lower spine to block pain signals coming from the hip region. Participants in this study will include adults aged 60 and older undergoing hip surgery for a femoral neck fracture under spinal anesthesia. Participants will be randomly assigned (like flipping a coin) to receive either the PENG block or the Lumbar ESPB before their surgery. Both blocks are performed under ultrasound guidance to ensure precise medication placement. Researchers will compare: * Pain levels at rest and during movement over the first 48 hours after surgery. * The total amount of additional pain medication (opioids) required. * Leg muscle (quadriceps) strength after surgery. * Any side effects or complications, as well as the overall length of hospital stay. The findings from this study will help doctors determine which nerve block provides better pain relief while preserving leg strength, aiding in safer and faster recovery for elderly patients after hip surgery.
Official title: Lumbar Erector Spinae Plane Block Versus Pericapsular Nerve Group (PENG) Block in Patients With Fracture Neck of Femur Undergoing Hip Surgery: A Randomized, Double-Blind, Controlled Trial
Key Details
Gender
All
Age Range
60 Years - Any
Study Type
INTERVENTIONAL
Enrollment
64
Start Date
2026-10-01
Completion Date
2027-05-15
Last Updated
2026-11-02
Healthy Volunteers
No
Interventions
Pericapsular Nerve Group Block
Ultrasound-guided nerve block performed 20 minutes preoperatively in the supine position. A 22G echogenic needle is directed in-plane lateral-to-medial to target the fascial plane deep to the iliopsoas tendon. Following negative aspiration and hydrodissection (2-3 mL saline), 20-25 mL bupivacaine 0.25% (or 15-20 mL in frail/small patients) is injected in 3-5 mL aliquots.
Lumbar Erector Spinae Plane Block
Ultrasound-guided fascial plane block performed 20 minutes preoperatively in the lateral decubitus or sitting position. A 22G echogenic needle is advanced in-plane cranial-to-caudal to contact the L3 or L4 transverse process. Following negative aspiration and hydrodissection confirming muscle lifting, 25-30 mL bupivacaine 0.25% is injected in 3-5 mL aliquots.
Locations (1)
Beni-Suef University Hospital
Banī Suwayf, Egypt