{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T18:13:06Z","timestamp":1778523186211,"version":"3.51.4"},"reference-count":33,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The pericapsular nerve group block provides motor-sparing analgesia after total hip arthroplasty, but the optimal injectate volume and the role of dexamethasone remain unclear. Methods: In this prospective, randomized, quadruple-blinded trial, 120 patients undergoing total hip arthroplasty under spinal anesthesia were allocated to receive ultrasound-guided pericapsular nerve group block with 20 mL or 10 mL of 0.2% ropivacaine, with or without 4 mg dexamethasone. The primary outcome was time to first rescue opioid within 24 h. Secondary outcomes included opioid consumption, pain scores, quadriceps strength, inflammatory markers, and safety. The study was designed as a superiority trial and was not powered to assess non-inferiority between volume groups. Results: Dexamethasone significantly prolonged time to first rescue opioid (hazard ratio 0.08, 95% confidence interval 0.04\u20130.16; p &lt; 0.0001). Injectate volume had no significant effect on the primary outcome (p = 0.13), and no interaction between dexamethasone and volume was observed. Total opioid consumption at 48 h was lower in patients receiving dexamethasone (mean difference \u22123.88 mg oral morphine equivalents; p &lt; 0.0001). Pain scores were consistently lower with dexamethasone, while injectate volume had no effect. Quadriceps strength was preserved in all groups. No nerve injury or clinically relevant hyperglycemia was observed. Conclusions: Dexamethasone improves analgesic efficacy of the pericapsular nerve group block after total hip arthroplasty. Reducing injectate volume from 20 mL to 10 mL did not significantly affect the analgesic outcomes; however, the study was not designed to assess non-inferiority. These findings support a strategy of volume optimization in regional anesthesia.<\/jats:p>","DOI":"10.3390\/jcm15103676","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:17:42Z","timestamp":1778519862000},"page":"3676","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low-Volume Versus Standard-Volume Pericapsular Nerve Group Block with and Without Dexamethasone for Postoperative Analgesia After Total Hip Arthroplasty: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4565-9880","authenticated-orcid":false,"given":"Tomasz","family":"Reysner","sequence":"first","affiliation":[{"name":"Pathophysiology of Pain Unit, Department of Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3245-6614","authenticated-orcid":false,"given":"Bahadir","family":"Ciftci","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Istanbul Medipol University, 34726 Istanbul, Turkey"},{"name":"Department of Anesthesiology and Reanimation, Istanbul Medipol University, 34214 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selcuk","family":"Alver","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Biruni University Hospital, 34295 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Wieczorowska-Tobis","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9067-0969","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Reysner","sequence":"additional","affiliation":[{"name":"Department of Clinical Anesthesiology and Pain Management, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Patel, I., Nham, F., Zalikha, L., and El-Othmani, M.M. 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