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NCT Number: NCT07078773

Application of Pericapsular Nerve Group (PENG) Block

This study aims to determine the efficacy and safety of the Pericapsular Nerve Group (PENG) block in preventing obturator nerve reflex during transurethral resection of bladder tumors.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

TURBT Bites and Stings Chemically-Induced Disorders Poisoning Wounds and Injuries

Age range

18 year–79 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Nanjing First Hospital

Nanjing, Jiangsu, 210006, China

About this study

During transurethral resection of bladder tumors (TURBT), obturator nerve reflex is easily triggered during electrocautery. Currently, two primary methods are used to prevent obturator nerve reflex: deep neuromuscular blockade under general anesthesia and obturator nerve block. To date, no studies have confirmed the efficacy of the Pericapsular Nerve Group (PENG) block in preventing obturator nerve reflex.

This study recorded the percentage decrease in adductor muscle strength at various time points after the PENG block, the occurrence of intraoperative adductor muscle spasms, the duration of nerve block procedure, and the incidence of postoperative adverse events. The completion of this study could provide clinical evidence for selecting anesthesia methods in TURBT procedures and offer robust evidence-based support for relevant medical decisions by government health agencies.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Aged 18 years or older;
  • Scheduled for TURBT for unilateral bladder tumor;
  • Able to understand and provide informed consent;

Exclusion criteria

  • Patients who refuse or are unable to provide informed consent;
  • Allergic to local anesthetics, insensitive to propofol or general anesthetics;
  • Pregnant women;
  • Severe liver dysfunction;
  • Evidence of infection at or near the proposed puncture site;
  • Any sensory or motor impairment of the lower limbs;
  • Recent (within 6 months) lower limb joint replacement surgery.

Treatment and study plan

PENG block

Procedure

A convex ultrasound probe (frequency 2-5 MHz) was positioned at the patient's inguinal ligament, with one end directed toward the anterior inferior iliac spine (AIIS), clearly visualizing the bony prominences of the iliopubic eminence and the AIIS. The needle tip was directed medially toward the pectineus muscle. Upon reaching the space between the pectineus muscle and the pubic bone, and after confirming the absence of blood on aspiration, 30 ml of 0.375% ropivacaine was injected.

Obturator nerve block

Procedure

An ultrasound probe was positioned at the inguinal ligament, with the needle inserted parallel to the long axis of the probe. After confirming no blood upon aspiration, 15 ml of 0.375% ropivacaine was injected into the fascial plane between the adductor brevis and adductor magnus, as well as into the midportion of the adductor longus and adductor brevis muscles.

Primary outcomes

  1. the percentage reduction in adductor muscle strength at 5, 10, 15, 20, 25, 30 minutes, and 3 hours after drug administration, compared to pre-administration levels.

    Time frame: 5, 10, 15, 20, 25, 30 minutes, and 3 hours post-administration

    The percentage increase in adductor strength from preoperative to postoperative measurements divided by preoperative adductor strength is larger, reflecting a better nerve block effect and superior obturator nerve reflex inhibition.

Secondary outcomes

  1. Presence of obturator nerve reflex during surgery

    Time frame: During surgery

    Obturator nerve reflex grading system: No response in the adductor muscle group of the thigh; mild muscle twitching in the adductor muscle group of the thigh; severe contraction of the adductor muscle group of the thigh

Other outcomes

  1. Physician Satisfaction Score

    Time frame: Up to 48 hours postoperative

    Grading:

    Excellent (1 point) Good (2 points) Fair (3 points) Poor (4 points) Higher scores indicate superior inhibition of obturator nerve reflex and better block efficacy

  2. Incidence of adverse reactions such as local anesthetic toxicity and nerve injury post-administration.

    Time frame: Up to 48 hours postoperative

    The lower the incidence of adverse reactions such as local anesthetic toxicity and nerve injury, the better the PENG block technique. quantifies safety profile (lower incidence indicates higher safety)

  3. Surgical Duration

    Time frame: During surgery

    Indirectly reflects interference from obturator nerve reflex; shorter duration implies effective reflex suppression

  4. Needle Pass Count

    Time frame: During nerve block procedures

    Fewer passes indicate simpler operation and higher precision.

  5. Operational Duration of Nerve Block

    Time frame: During nerve block procedures

    Reflects procedural convenience; shorter duration indicates simpler technique

  6. Patient Satisfaction Score Patient Satisfaction Score Patient Satisfaction Score

    Time frame: Up to 48 hours postoperative

    Grading:

    Excellent (1 point) Good (2 points) Fair (3 points) Poor (4 points) Higher scores reflect enhanced patient comfort during the procedure

Sponsors and collaborators

Lead sponsor

Nanjing First Hospital, Nanjing Medical University

Other

Registry information

Official study title

Application of Pericapsular Nerve Group (PENG) Block in Transurethral Resection of Bladder Tumors

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jul 22, 2025
Registry last updated
Aug 13, 2025

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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