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NCT Number: NCT07771829

QLESP Block Versus PENG+LFCN Block for Total Hip Arthroplasty

Total hip arthroplasty (THA) is a common surgery to replace damaged hip joints, but many patients experience significant pain after surgery, which can delay recovery and increase the need for strong pain medications (opioids). Nerve blocks are a technique where anesthetic medication is injected near specific nerves to reduce pain. This study compares two different ultrasound-guided nerve block techniques for pain control after THA: the QLESP block (a newer technique that targets two areas with a single injection) and the PENG block combined with the LFCN block (a currently used technique that targets nerves around the hip joint and the outer thigh). Participants in this study will be randomly assigned (like a coin flip) to receive either the QLESP block or the PENG+LFCN block after surgery. The study aims to determine which nerve block provides better pain relief and reduces the need for opioid pain medications in the first 24 hours after surgery. Pain scores, recovery of leg movement, time to first walk, length of hospital stay, and any side effects will also be compared between the two groups.

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Key information

Conditions

Pain Management Agnosia Arthroplasty Total Hip Replacement Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pathological Conditions, Signs and Symptoms Perceptual Disorders Signs and Symptoms

Age range

18 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, 430022, China

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18 to 70 years
  • Scheduled for elective unilateral total hip arthroplasty via posterolateral approach
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Body mass index (BMI) < 35 kg/m²
  • Ability to understand pain scoring and patient-controlled analgesia (PCA) use
  • Willing and able to provide written informed consent

Exclusion criteria

  • Allergy or hypersensitivity to local anesthetics (ropivacaine)
  • Long-term opioid use or chronic pain history requiring regular analgesic use
  • Active malignancy or infection at the puncture site
  • Severe psychiatric disorders or communication barriers
  • Severe cardiopulmonary disease
  • History of opioid abuse or substance dependence
  • Participation in another interventional clinical trial within 3 months prior to enrollment
  • Coagulation abnormalities
  • Pregnancy or breastfeeding
  • Any condition that, in the investigator's opinion, would compromise patient safety or data integrity

Treatment and study plan

QLESP Block

Procedure

Ultrasound-guided quadratus lumborum and modified erector spinae plane block. A single-puncture, dual-injection technique at the L4 level. Total volume: 30 mL of 0.375% ropivacaine.

PENG+LFCN Block

Procedure

Ultrasound-guided pericapsular nerve group block combined with lateral femoral cutaneous nerve block. PENG: 20 mL of 0.375% ropivacaine; LFCN: 10 mL of 0.375% ropivacaine.

Ropivacaine

Drug

Ropivacaine hydrochloride injection, 0.375% solution, administered as a single dose via ultrasound-guided nerve block. Total dose: 112.5 mg (30 mL of 0.375% solution) for the QLESP group; 112.5 mg (30 mL of 0.375% solution) for the PENG+LFCN group.

Primary outcomes

  1. Postoperative 24-Hour Cumulative Opioid Consumption

    Time frame: At 24 hours after surgery

Secondary outcomes

  1. Postoperative VAS Pain Scores

    Time frame: At 6, 12, 24, 36, and 48 hours after surgery

    The Visual Analogue Scale (VAS) is a 10-cm line ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate worse pain. Pain scores are assessed at rest and during movement (passive hip flexion to 15 degrees) at each time point.

  2. Rescue Analgesia Requirement

    Time frame: Within 24 hours after surgery

  3. Motor Block Assessment (Bromage Score)

    Time frame: At 6, 24, and 48 hours after surgery

    The Bromage Score is a 4-point scale ranging from 0 (no motor block, able to perform full knee flexion and foot dorsiflexion against resistance) to 3 (complete motor block, unable to move knee or foot). Higher scores indicate worse motor function. Assessed on the operative side at each time point. A score of 0-1 is considered clinically acceptable for early ambulation.

  4. Time to First Ambulation

    Time frame: From surgery end to first walk, up to 7 days

  5. Length of Hospital Stay

    Time frame: From surgery date to discharge, up to 30 days

  6. Incidence of Adverse Events

    Time frame: From surgery end to 48 hours after surgery

Study contacts

Contact information is provided by the study sponsor or research team.

Xi Wu

CONTACT

[email protected]

+8615871715431

Sponsors and collaborators

Lead sponsor

Huazhong University of Science and Technology

Other

Registry information

Official study title

Comparison of Ultrasound-Guided QLESP Block Versus Pericapsular Nerve Group Block Combined With Lateral Femoral Cutaneous Nerve Block on Postoperative Analgesia and Functional Recovery in Total Hip Arthroplasty: A Randomized Controlled Trial

Acronym: QLESP

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Aug 18, 2026
Registry last updated
Aug 18, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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