Study: NCT06736392

Intervention type: PROCEDURE
Group type: ACTIVE_COMPARATOR
Intervention: Ultrasound guided Pericapsular Nerve Group Block
Description: With the patient in the supine position and the leg slightly abducted, a curvilinear transducer (2.5-7.5 MHz) is prepared with sterile conduction gel and covered with a sterile probe cover. The transducer is placed transversely over the anterior superior iliac spine (ASIS), then aligned with the pubic ramus and rotated approximately 45° parallel to the inguinal crease. The probe is slid medially to identify key landmarks: the anterior inferior iliac spine (AIIS), iliopubic eminence (IPE), iliopsoas tendon, femoral artery, and femoral nerve. Sliding the probe distally or tilting caudally exposes the femoral head.~A 20-22 gauge echogenic needle (100 mm) is inserted in-plane from lateral to medial, targeting the plane between the psoas tendon and the pubic ramus. the anesthetic agent is deposited to lift the psoas tendon while avoiding tendon puncture.

Intervention type: PROCEDURE
Group type: ACTIVE_COMPARATOR
Intervention: Ultrasound guided Pericapsular Nerve Group Block
Description: With the patient in the supine position and the leg slightly abducted, a curvilinear transducer (2.5-7.5 MHz) is prepared with sterile conduction gel and covered with a sterile probe cover. The transducer is placed transversely over the anterior superior iliac spine (ASIS), then aligned with the pubic ramus and rotated approximately 45° parallel to the inguinal crease. The probe is slid medially to identify key landmarks: the anterior inferior iliac spine (AIIS), iliopubic eminence (IPE), iliopsoas tendon, femoral artery, and femoral nerve. Sliding the probe distally or tilting caudally exposes the femoral head.~A 20-22 gauge echogenic needle (100 mm) is inserted in-plane from lateral to medial, targeting the plane between the psoas tendon and the pubic ramus. the anesthetic agent is deposited to lift the psoas tendon while avoiding tendon puncture.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Isobaric Bupivacaine 0. 25%
Description: group c will receive PENG block with only 20ml isobaric bupivacaine 0.25%

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: 20 ml isobaric bupivacaine 0.25% and 1.5μg/kg dexmedetomidine
Description: group D will receive PENG block with 20 ml isobaric bupivacaine 0.25% and 1.5μg/kg dexmedetomidine

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: the ultrasound machine with curvilinear transducer (high -frequency probe, 2.5Mhz to 7.5Mhz)
Description: the two groups will receive the PENG block under ultrasound guidance

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: the ultrasound machine with curvilinear transducer (high -frequency probe, 2.5Mhz to 7.5Mhz)
Description: the two groups will receive the PENG block under ultrasound guidance

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: a standard echogenic 20-22 gauge 100mm needle
Description: the two groups will receive the PENG block using a standard echogenic 20-22 gauge 100mm needle

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: a standard echogenic 20-22 gauge 100mm needle
Description: the two groups will receive the PENG block using a standard echogenic 20-22 gauge 100mm needle