QLESP Block Versus PENG+LFCN Block for Total Hip Arthroplasty

Background: Total hip arthroplasty (THA) is a common orthopedic procedure, butpostoperative pain remains a significant challenge that can delay recovery and increaseopioid consumption. Regional nerve blocks are a key component of multimodal analgesia.The QLESP block is a novel single‐puncture, dual‐plane technique developed by our group,while the PENG+LFCN block is a currently used motor‐sparing technique. However, norandomized controlled trial has directly compared these two approaches.Objective: This study aims to compare the analgesic efficacy and functional recoveryoutcomes of QLESP block versus PENG+LFCN block in patients undergoing THA.Design: This is a single‐center, prospective, randomized, assessor‐blinded,parallel‐controlled trial. Participants will be randomly assigned in a 1:1 ratio toreceive either QLESP block or PENG+LFCN block after surgery. All participants willreceive standardized general anesthesia and postoperative multimodal analgesia.Exploratory biomarker sub‐study: An exploratory sub‐study will analyze plasma proteomicprofiles in a subset of participants to identify potential molecular mechanismsunderlying differences in pain response. Blood samples will be collected at baseline and24 hours postoperatively. This analysis is exploratory and hypothesis‐generating.Sample size: A total of 140 participants will be enrolled (70 per group). Follow‐up:Participants will be followed for 48 hours after surgery.