A comparative study of 0.2% ropivacaine with dexamethasone versus fentanyl in PENG block

The PENG block is recognized for its motor-sparing effect, setting it apart from the femoral nerve block. This interfascial plane block provides good analgesia for proximal femur fracture surgeries. The primary objective of the research was to analyze the efficacy of Dexamethasone and Fentanyl with Ropivacaine in PENG block for proximal femur surgeries, while the secondary objective was to evaluate the comfort of patients while positioning for spinal anesthesia and any potential side effects. The study involved 60 patients, classified as ASA grade I/II, split into two groups of 30. Group PD was given 0.2%Ropivacaine (15ml), with Dexamethasone 4mg, and Group PF was given 0.2% Ropivacaine (15ml), with Fentanyl 50mcg in USG guided PENG block. The study documented VAS score before and 10 minutes after the PENG block, patient satisfaction score, postoperative duration of analgesia, hemodynamic effects and adverse effects. In both the groups, VAS score before (6.567±1.223 vs6.5±1.252, p=0.408) and 10 minutes after PENG block (2.167±0.791vs2.234±0.728, p=0.365) and patient satisfaction score (2.1±0.759vs2±0.743, p=0.328) were comparable i.e. statistically insignificant. The postoperative duration of analgesia (655.334±35.457 mins in group PD vs 458.334±27.518 mins in group PF, p- value=0.004), was statistically significant. No significant hemodynamic effects or side effects were observed. PENG block has the potential to be beneficial for both preoperative positioning and postoperative pain management. We conclude that Dexamethasone (4mg) and Fentanyl (50 mcg) provide comparable analgesic efficacy as an adjuvant to 0.2% Ropivacaine in the early postoperative period, but Dexamethasone provides a prolonged duration of analgesia.