Supra-Iliac Anterior Quadratus Lumborum Block and Pericapsular Nerve Group (PENG) Block for Analgesia After Total Hip Arthroplasty

A Randomized Clinical Non-Inferiority Trial Comparing Supra-Iliac Anterior Quadratus Lumborum Block and Pericapsular Nerve Group (PENG) Block for Analgesia After Total Hip Arthroplasty

This study aims to compare the analgesic efficacy of supra-iliac anterior quadratus lumborum block (SA-QLB) and pericapsular nerve group (PENG) block in patients undergoing total hip arthroplasty (THA).

Total hip arthroplasty (THA) is one of the most common elective orthopedic procedures, performed to restore mobility, alleviate pain and improve quality of life in patients with degenerative hip joint disease. Its rate is projected to further increase with aging of the population worldwide.

Pericapsular nerve group (PENG) block is a fascial block targets periarticular sensory branches derived from the femoral, obturator and accessory obturator nerves innervating the anterior hip capsule.

The ultrasound-guided quadratus lumborum block (QLB) is a regional anesthetic technique with many described approaches: the lateral QL (QL1) block, the posterior QL (QL2) block, and the anterior QL (transmuscular) block.

Inclusion Criteria:

• Age from 18 to 75 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) classification I-III.
• Scheduled for primary elective unilateral total hip arthroplasty (THA) under spinal anesthesia.

Exclusion Criteria:

• Known allergies to the drugs used.
• Infection at the injection site.
• Bleeding disorders.
• Recognized neuromuscular disorders.
• Opioid addiction or dependence.
• Contraindications to regional anesthesia or peripheral nerve blockade.
• Body mass index (BMI) > 40 kg/m².
• Associated decompensated cardiac, hepatic, respiratory, or renal diseases.