Background and aims Pericapsular nerve group (PENG) block is a novel analgesic method explained recently for analgesia of proximal hip fracture. We report a case of analgesia for a right proximal hip fracture in a 60 year old male using PENG block.
Methods A low frequency curvilinear probe (2–5 MHZ) was first placed over the right anterior inferior iliac spine and medial part of probe was rotated towards pubic rami to identify the relevant anatomical structures, namely iliopubic eminence,psoas muscle and femoral artery. A 22G 100mm short bevelled blunt needle was inserted from the lateral aspect of the problem via inplane approach to reach the target, which was the plane between psoas muscle and iliopubic eminence. After negative aspiration around 25 ml of 0.25%bupivacaine with 8 mg dexamethasone was injected in the plane between iliopubic eminence and psoas muscle. A linear spread of local anesthetic was noticed.
Results Pain score was assessed using numerical rating scale (NRS). NRS prior to PENG block was 8/10. NRS was 2/10 after 15 minutes of block and 0/10 after 1 hour of block. The patient remained pain free for almost 24 hours after PENG block. There were no complications after the block.
Conclusions PENG is a novel analgesic technique for analgesia of proximal hip fracture. Further RCTs are required to compare the efficacy of PENG block with other methods of analgesia for proximal hip fractures.
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