MRI-Based Assessment of Local Anesthetic Spread in the PENG Block Compartment

N/ANot Yet RecruitingNCT07040423

Campus Bio-Medico University6 enrolled

Overview

This study uses MRI imaging to evaluate the spread of local anesthetic following the administration of a pericapsular nerve group (PENG) block. The goal is to determine whether a distinct fascial plane exists between neurovascular structures, potentially explaining the block's observed clinical effectiveness.

The pericapsular nerve group (PENG) block has demonstrated promising clinical results in providing analgesia for hip-related pain, particularly in patients with femoral neck fractures or undergoing hip surgery. However, the exact mechanism of action and spread of local anesthetic remain poorly understood. This pilot study aims to use magnetic resonance imaging (MRI) to visualize the distribution pattern of the injectate after PENG block administration. High-resolution MRI scans will be obtained shortly after the procedure to assess the spatial relationship between the spread of local anesthetic, relevant anatomical structures (including the iliopsoas muscle, femoral artery, and femoral nerve), and potential fascial compartments. The findings will help to clarify the anatomic basis of the PENG block and may guide optimization of technique for enhanced clinical outcomes.

Study Type

INTERVENTIONAL

Allocation

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Total Hip Arthroplasty (THA)Postoperative Pain Management After Total Hip Arthroplasty

Interventions

PENG BlockPROCEDURE

Preoperative ultrasound giuded PENG block (ropivacaine 0,5% 20mL)

Magnetic resonance imagingPROCEDURE

The patient will undergo a pelvic MRI to assess anesthetic diffusion after PENG block

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients scheduled for total hip replacement surgery * Age ≥ 18 years * ASA physical status classification I-III * Signed informed consent obtained * Orthopedic indication for preoperative MRI study Exclusion Criteria: * Allergy to local anesthetics * Infection at the planned puncture site * Refusal or inability to provide informed consent * Age \< 18 years * Claustrophobia * Altered consciousness or severe dementia * Presence of MRI-incompatible implanted devices (e.g., pacemakers implanted before 2000) * Pregnancy or breastfeeding

Locations (1)

Policlinico Universitario Campus Bio-Medico

Roma, Italy, Italy

Outcomes

Primary Outcomes

Extent of local anesthetic spread as visualized on MRI after PENG block administration

MRI images will be used to assess the diffusion pattern of local anesthetic following PENG (Pericapsular Nerve Group) block. The assessment will focus on whether the anesthetic reaches a specific fascial plane between the femoral vessels and nerves. A radiologist will evaluate the extent and location of the anesthetic spread in relation to key anatomical landmarks (according to centimeter-based measurements as per MRI protocols).

Time frame: 10 minutes after injection

Data from ClinicalTrials.gov

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