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OP044 Comparison of local anaesthetic concentration in pericapsular nerve group (PENG) block for total hip arthroplasty: a prospective randomized double-blind controlled trial
  1. İlke Akay Akgül1,
  2. Nur Canbolat1,
  3. Mehmet I Buget1,
  4. Demet Altun1,
  5. Cengiz Şen2 and
  6. Kemalettin Koltka1
  1. 1Department of Anaesthesiology, Istanbul Faculty of Medicine, Istanbul, Turkey
  2. 2Department of Orthopaedics and Traumatology, Istanbul Faculty of Medicine, Istanbul, Turkey


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Background and Aims PENG block is a novel regional method in hip surgeries that provides adequate postoperative analgesia without motor weakness. The aim of this study was to compare the postoperative analgesia effectiveness of PENG block with different local anaesthetic doses in total hip arthroplasty(THA) surgeries.

Methods 91 patients aged 18-80 years, ASA I-III, undergoing THA surgery under spinal anaesthesia and PENG block were included in this prospective randomized controlled study registered with the Clinical Trials(NCT04900116). The patients were divided into 4 groups using a computer software. PENG block; 20ml of 0.5%bupivacaine in Group-1, 20ml of 0.25%bupivacaine in Group-2, 20ml of 0.125%bupivacaine in Group-3 and 20ml of saline in Group-4 as control group. VAS score, morphine consumption, nausea-vomiting, quadriceps weakness was evaluated at 0,6,12,24, and 48hours postoperatively. In addition, the first mobilization time, breakthrough opioid need, hospital stay, patient and surgeon satisfaction, preoperative and postoperative 1-month Beck-depression scores and complications were recorded.

Results In Groups-1&2, VAS scores and morphine consumption were significantly lower than the control group(p=0.001,p=0.001,respectively). Quadriceps weakness was significantly higher in Group-1 at 0th hour(p=0.011). Nausea and vomiting were significantly lower in Group-1 than the other groups at the 12th and 24th hours(p=0.007,p=0.027,respectively). The length of hospital stay was significantly shorter in Group-1 compared to the control group(p=0.048).

Abstract OP044 Table 1

Evaluation of morphine consumption by groups

Abstract OP044 Table 2

Comparison of quadriceps weakness by groups

Abstract OP044 Table 3

Comparison of first mobilization time, breakthrough morphine and length of hospital stay by groups

Conclusions We believe that PENG block applied with 20ml 0.5%bupivacaine in THA surgeries provides more ideal postoperative analgesia by reducing opioid side effects and hospital stay with low pain scores and morphine consumption despite early quadriceps weakness.

  • PENG block
  • total hip arthroplasty
  • postoperative pain management

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