Background and Aims Ambulatory hip arthroscopies are associated with severe pain requiring opioid analgesia. Novel motor sparing blocks, the pericapsular nerve group (PENG) and lateral femoral cutaneous nerve block (LFCN) have been reported with efficacy in hip surgery. The purpose of this study is to investigate the analgesic benefits of these novel blocks in terms of opioid-sparing and discharge efficiency.
Methods After obtaining institutional review board approval (IRB # 2020-2031), we retrospectively identified 1559 patients who underwent elective hip arthroscopy at our institution from January 2019 to December 2020. We used propensity scores to match each block group (PENG, PENG/LFCN) to a control group (neuraxial only). The outcomes of interest include post-anesthesia care unit (PACU) mean opioid consumption, maximum NRS pain score, intravenous rescue analgesia and PACU readiness for discharge times.
Results PENG/LFCN block group required significantly less opioids in the PACU (25.98 ± 13.04 versus 14.58 ± 5.77, p <.001) and were discharged earlier
2.72 ± 1.16 hours versus 4.42 ± 1.63 hours, p <.001) than the control group. The combined PENG/LFCN group also used less intravenous rescue opioids (0.47±1.18 mg versus 1.44±2.1 mg, p = 0.099) than the control group. The PENG block alone group did not show a significant difference in opioid reduction (21.95± 15.83 versus 27.72± 15.01, p = 0.108), but was discharged from the PACU earlier (3.62± 1.35 versus 45.5± 3.2 hours, p
= 0.002). (table 1)
Conclusions Combined PENG and LFCN block were associated with expedited PACU discharge and a clinically significant reduction in post-operative opioid use.
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