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Abstract
Background and Aims This study aimed to compare the effect of the pericapsular nerve group (PENG) block with suprainguinal fascia iliaca compartment block (FICB) on dynamic pain during the positioning for spinal anesthesia as well as postoperative pain and motor blockade.
Methods In this study, 79 patients undergoing surgery for hip fractures with baseline pain scores of ≥ 4 using the numerical rating scale (NRS) were randomly allocated to receive either an ultrasound-guided PENG block (n = 40) or a suprainguinal FICB (n = 39). The primary outcome was to assess the reduction of pain scores during hip flexion for spinal anesthesia 30 minutes after the peripheral nerve block. Secondary outcomes included the pain score at postoperative 6, 24, and 48 hours, cumulative opioid consumption up to postoperative 24 and 48 hours, postoperative intensity of motor blockade and cognitive dysfunction, and postoperative complications.
Results The study found that both FICB and PENG block reduced dynamic pain during hip flexion for spinal anesthesia, with no significant difference between the two groups (- 2.90 ± 2.52 vs. – 3.08 ± 2.43; P = 0.75). There was also no significant difference between the two groups in pain scores (static and dynamic) at 6, 24, and 48 hours postoperatively, intensity of motor blockade, time to ambulation, or other outcomes.
Characteristics of the two groups
Suprainguinal fascia iliaca compartment block (FICB). AIIS, anterior inferior iliac spine; DCIA, deep circumflex iliac artery; FI, fascia iliaca; LA, local anesthetic; N, needle
Pericapsular nerve group (PENG) block. AIIS, anterior inferior iliac spine; FA, femoral artery; IPE, iliopubic eminence; N, needle; PT, psoas tendon
Conclusions In patients with hip fractures, the PENG block may provide a comparable analgesic effect to suprainguinal FICB on dynamic pain during position change for spinal anesthesia, with no difference in postoperative pain and motor blockade.