Background and Aims Early ambulation and initiation of physiotherapy following total hip arthroplasty (THA) are essential in diminishing pain and avoiding complications. This audit compared the effectiveness of two popular blocks: the pericapsular nerve group (PENG) and the fascia iliaca block (FIB). Audit approval was granted by our local audit department without ethics committee approval.
Methods We retrospectively analysed 57 elective patients undergoing THA in University Lewisham Hospital. Patients were divided into two groups: those undergoing PENG (group 1) and those undergoing FIB (group 2). Demographic data, morphine equivalent requirements (MER) at day 1 and 2, earliest mobilisation, hip flexion angles, and numeric rating scores (NRS) were recorded. Data was analysed using SPSS statistical software.
Results Nineteen patients (33.3%) underwent PENG and 38 (66.7%) patients underwent FIB. Patients in group 1 were found to have a significantly greater degree of hip flexion when compared to those undergoing FIB (p=0.008). Additionally, patients in group 1 appeared to have near significant lower day 2 resting NRS (p=0.06). However, when analysing NRS scores overall there was no significant difference between the two groups. Additionally, there was no significant difference between mean MER doses at day 1 or 2.
Conclusions In patients undergoing THA, addition of a PENG block can significantly improve hip flexion ranges and may improve resting NRS values when compared to those undergoing FIB. We therefore suggest the addition of a PENG block may preserve hip motion and allow early physiotherapy initiation, all of which may lead to improved prosthesis function in the longer term.
Results table- THR audit docx