Comparing pericapsular nerve group block and fascia iliaca compartment block for intraoperative and postoperative analgesia in hip surgeries in pediatrics: a randomized controlled trial

Acute postoperative pain in pediatric patients can profoundly influence emotional state, behavior, and recovery outcomes. Both the suprainguinal fascia iliaca compartment (S-FICB) and the pericapsular nerve group (PENG) blocks have been associated with effective pain relief. This investigation evaluated PENG and S-FICB blocks on analgesia quality both during and after surgeries in children experiencing hip surgeries. In this randomized, controlled trial, 60 children (aged 1–6 years) of both sexes experiencing hip surgeries were enrolled. Subjects were randomized to undergo either a PENG block (Group P) or an S-FICB (Group F) after induction of anesthesia and before the surgical procedure began, with 0.5 mL/kg of 0.25% bupivacaine. Group P showed significantly lower mean arterial pressure and heart rate at 30, 40, and 50 min during surgery (P < 0.05). The time to 1st rescue analgesic was significantly longer in Group P (P < 0.001), with a substantial reduction in morphine consumption over 24 h (P < 0.001). Rates of bradycardia, hypotension, and postoperative nausea and vomiting were comparable across groups. No respiratory depression or block failure occurred. The PENG block was associated with differences in analgesic outcomes compared to the FICB in pediatric hip surgeries, with lower intraoperative hemodynamic measures at 30, 40, and 50 min intraoperatively, longer time to rescue analgesia, and reduced opioid requirements. The trial was retrospectively registered before patient enrollment at the Pan African Clinical Trial Registry (PACTR202505776642894, Date of registration: May 21, 2025).