Pericapsular nerve group (PENG) block compared to intrathecal morphine for analgesic efficacy in total hip arthroplasty: A placebo-controlled randomized double-blind non-inferiority trial
Authors' conclusion
Compared to IT morphine, PENG block provides non-inferior analgesia after THA under spinal anesthesia without additional compromise of the motor function.
Study context
- Population
- Patients undergoing unilateral total hip arthroplasty (THA) under spinal anaesthesia1:1
- Participants
- 60 patients
- Comparison
- PENG block vs intrathecal (IT) morphine
- Primary endpoint
- Co-primary: maximum pain at rest and at active hip flexion (0-10 NRS, overall period) and MME over 48 h
- Follow-up
- 48 h
Methodological detailsdouble-blind, placebo-controlled, non-inferiority
- Double-blind
- Placebo-controlled
- Non-inferiority
Primary result
As reported in the abstract
Co-primary: maximum pain (NRS) and MME
PENG block vs IT morphineEstimate (95 % CI)
Non-inferiority margin 0.75 NRS points; well below margin
difference (maximum pain at rest) 0.182 NRS points(−0.218 to 0.582)
Non-inferiority margin 0.75 NRS points; well below margin
difference (maximum pain at hip flexion) −0.270 NRS points(−0.990 to 0.453)
Non-inferiority margin 0.75 as printed, not drawn
PENG block vs IT morphineDifference (MME over 48 h), MME (95 % CI)
Non-inferiority margin 10 MME; well below margin
−2.1(−6.5 to 1.9)
Non-inferiority margin 0.75 as printed, not drawn
Safety
%
| Outcome | PENG block | IT morphine | Difference (95 % CI) | |
|---|---|---|---|---|
| Straight leg raise test failure (age-adjusted) · 4, 6 and 12 hAge-adjusted | 11.7 | 12.8 | −1.1 (−9.7 to 7.5) | |
| −10−50510Difference (linear scale) |
Straight leg raise test failure (age-adjusted) · 4, 6 and 12 h
- Similar in the two groups
Original publication
Pericapsular nerve group (PENG) block compared to intrathecal morphine for analgesic efficacy in total hip arthroplasty: A placebo-controlled randomized double-blind non-inferiority trial. J Clin Anesth. Published 2 July 2025. doi:10.
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