Background and aims First described in 2018, the PENG block is gaining popularity for its provision of targeted anaesthesia of the articular branches of the hip. Our aim was to evaluate its perioperative analgesic efficacy in patients undergoing surgical fixation of neck of femur fractures.
Methods With local audit committee authorisation, data was retrospectively collected from patients undergoing surgical fixation of neck of femur fractures at Frimley Park Hospital, UK. Electronic anaesthetic records and drug charts were reviewed.
Results 14 patients were identified, with a heterogenous mix of regional techniques used. 93% of PENG blocks were performed in the anaesthetic room immediately prior to surgery. Femoral nerve blocks were the most commonly added block, but over a third of cases had the combination of PENG and lateral femoral cutaneous nerve (LFCN) blocks. Two-thirds of patients had a spinal anaesthetic; no supplemental sedation nor analgesia was required for positioning 78% of these patients. Median time to first postoperative opioid administration was 160 minutes. Average opioid consumption in the first 24 postoperative hours was equivalent to 13.6 mg of oral morphine. 4 patients (29%) required no opioid analgesia in the first 48 hours postoperatively; 2 had a combination of PENG and LFCN blocks.
Conclusions In a cohort of patients with high perioperative morbidity and mortality, provision of optimal analgesia and opioid sparing techniques is essential. We believe combined PENG and LFCN blocks will provide ideal articular and incisional analgesia for surgical fixation. Further work needs to be conducted analysing this specific combination and direct comparisons made with standard practice.