Intravenous Dexamethasone (0 vs 4 vs 8 mg) as an Adjunct to PENG Block for Postoperative Analgesia in Total Hip Arthroplasty: A Randomized Double-Blind Trial
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Dexamethasone 4mg, Placebo, Dexamethasone 8mg.
- Who it may be relevant to
- Registry conditions: Osteoarthritis, Hip, Hip Osteoarthritis. Basic parameters: 18 years — 100 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Poland
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial Evaluating Intravenous Dexamethasone (0 vs 4 vs 8 mg) as an Adjunct to PENG Block for Postoperative Analgesia in Total Hip Arthroplasty
Overview
his study will test whether giving dexamethasone through a vein can improve pain control after total hip replacement surgery. Dexamethasone is commonly used to reduce nausea and may also help with pain, but it is not clear which dose works best. Patients will be randomly assigned to receive either no dexamethasone, 4 mg, or 8 mg, in addition to standard anesthesia and a nerve block (PENG block). The main goal is to see how long patients go without needing additional pain medication after surgery. The study will also look at pain levels, use of opioid painkillers, nausea and vomiting, blood sugar levels, and possible side effects.
Detailed description
Effective pain control after total hip arthroplasty (THA) remains a key component of perioperative care, as inadequate analgesia may delay mobilization, prolong hospital stay, and increase the need for opioids. Regional anesthesia techniques, such as the pericapsular nerve group (PENG) block, are increasingly used to improve postoperative pain management while preserving motor function.
Dexamethasone administered intravenously is commonly used in perioperative care, primarily for the prevention of postoperative nausea and vomiting. In addition, it has been shown to prolong the duration of analgesia when used as an adjunct to regional anesthesia. However, there is still uncertainty regarding the optimal intravenous dose that provides clinically meaningful analgesic benefit without increasing the risk of adverse effects, particularly hyperglycemia.
Previous studies have typically used doses ranging from 4 mg to 8 mg, but direct comparisons between these doses, as well as comparison with placebo, remain limited in patients undergoing THA. Furthermore, the potential dose-response relationship of intravenous dexamethasone in this specific surgical population has not been clearly established.
This study is designed to address this knowledge gap by evaluating whether intravenous dexamethasone provides additional analgesic benefit in patients undergoing THA with PENG block, and whether higher doses result in improved outcomes compared to lower doses or no dexamethasone. The findings may help optimize perioperative analgesic strategies and support more evidence-based dosing of dexamethasone in orthopedic surgery.
Interventions
- Drug Dexamethasone 4mg
Intravenous dexamethasone administered as a single dose after induction of anesthesia, at doses of 4 mg - Drug Placebo
Intravenous administration of 0.9% sodium chloride in a volume identical to active treatment, given after induction of anesthesia. - Drug Dexamethasone 8mg
Intravenous dexamethasone administered as a single dose after induction of anesthesia, at doses of 8 mg
Primary outcome measures
- Time to First Rescue Analgesia [Time frame: 48 hours after surgery]
Secondary outcome measures (11)
- Postoperative Pain Intensity [Time frame: 6 hours after surgery]
- Postoperative Pain Intensity [Time frame: 12 hours after surgery]
- Postoperative Pain Intensity [Time frame: 24 hours after surgery]
- Postoperative Pain Intensity [Time frame: 48 hours after surgery]
- Opioid Consumption [Time frame: 48 hours after surgery]
- Opioid Consumption [Time frame: 24 hours after surgery]
- Incidence of Postoperative Nausea and Vomiting (PONV) [Time frame: 24 hours after surgery]
- Blood Glucose Levels [Time frame: immidietly after surgery (0 hours after surgery)]
- Blood Glucose Levels [Time frame: 6 hours after surgery]
- Blood Glucose Levels [Time frame: 12 hours after surgery]
- Blood Glucose Levels [Time frame: 24 hours after surgery]
Eligibility criteria
Inclusion criteria
- Age ≥ 18 years
- Scheduled for elective total hip arthroplasty (THA)
- Planned use of regional anesthesia including PENG block
- American Society of Anesthesiologists (ASA) physical status I-III
- Ability to understand the study procedures and provide written informed consent
- Ability to assess pain using the Numeric Rating Scale (NRS)
Exclusion criteria
- Known hypersensitivity to dexamethasone or any component of the study medication
- Chronic corticosteroid therapy or use of systemic steroids within 14 days prior to surgery
- Active systemic infection or sepsis
- Significant immunosuppression (e.g., chemotherapy, biological therapy)
- Pregnancy or breastfeeding
- Severe cognitive impairment or inability to reliably assess pain
- Uncontrolled diabetes mellitus (e.g., HbA1c > 8.5% or baseline blood glucose > 200 mg/dL)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Quadruple blind
- Primary purpose
- Treatment
Study locations
Poland · 1 center
- Poznan University of Medical Sciences — Poznan
Identifiers
NCT: NCT07581470 · 3/2026