Efficacy of Pericapsular Nerve Group Block (PENG BLOCK) in the Perioperative Period for Patients Undergoing Hip Surgery

Abstract Background Proximal femur fractures are common fractures especially in elderly population and produce routine problems for trauma. It is common that they lead to immobility or hindrance in daily life. In addition, elderly people can have surgical problems as well as multiple medical complications (Schuetze et al., 2019). Aim of the Work The study aimed to Studying the effect of the pericapsular nerve group (PENG) block on providing perioperative analgesia and improving functional recovery following total hip arthroplasty. Patients and Methods This prospective randomized controlled trial study was conducted in Ain Shams University Hospitals. Thirty six adult patients scheduled for proximal femur fracture fixation under spinal anaesthesia were included in this study. The patients' age was above 18 years old and with the American Society of Anaesthesiologists (ASA) Class I, II and III. At the the beginning of the surgery, patients were randomized using a random number table and the use of a closed envelopes technique were used to receive either ultrasound guided pericapsular nerve group block (PENG) block, or normal saline (no PENG block), each group constitutes 18 patients. Results As regarding time of 1st rescue analgesia our study revealed that there was significant shorter duration to first rescue analgesia in control group as mean time in control group was 13 hours compared to 19 hours in PENG group. As regarding to total morphine consumption our study revealed marked decrease in morphine consumption in the 1st 24 hours post operatively with mean 3mg in PENG group and 6mg in control group. As regarding the mobility after surgery we found that 17 patients out of 18 who received PENG block could stand at 24 hours post operatively in comparison to only 6 patients in control group. Conclusion The other aspect that should be discussed is that the PENG block provides only anterior hip capsule analgesia. Although the anterior capsule innervation is responsible for the majority of hip-related pain, it omits the posterior capsule, which is innervated by the nerve to the quadratus femoris and from the superior gluteal nerve, both from the sacral plexus.