Study Summary

Sixty patients undergoing total hip arthroplasty (THA) were randomized to receive a standard-volume pericapsular nerve group (PENG) block with 20 mL 0.2% ropivacaine or a low-volume PENG block with 10 mL 0.2% ropivacaine plus 4 mg perineural dexamethasone. The primary outcome of interest was time to first rescue opioid. Secondary outcomes of interest included total 48-hour opioid consumption, pain scores (NRS), quadriceps strength, inflammatory markers, and blood glucose levels. Outcomes were assessed up to 48 hours postoperatively at 4, 8, 12, and 24 hours. Overall, the results of the study revealed that the addition of dexamethasone significantly prolonged time to first opioid use and reduced opioid consumption while maintaining similar motor function. These findings suggest that dexamethasone may allow reduction in local anesthetic volume without compromising analgesic efficacy in PENG block for THA.