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Background and Aims The pericapsular nerve group (PENG) block is a novel regional analgesia technique to reduce pain after hip fracture surgery (1, 2). PENG blocks may be superior to fascia iliaca blocks for post-operative analgesia and its motor-sparing effects (2-4). This case series aimed to explore the feasibility of introducing the PENG block into a local enhanced recovery protocol for trauma patients with hip fracture.
Methods The case series was performed prospectively between January and April 2023 for 25 consecutive trauma patients undergoing hip fracture surgery in a UK district general hospital. All patients were consented prior to surgery to receive the PENG block alongside general anaesthesia or spinal anaesthesia. The use of intra-operative opioids and rescue opioids in recovery were collected. Subsequent oral opioid consumption and early mobilisation status were noted at 24 hours.
Results 15 out of 25 patients received general anaesthesia with the remainder receiving a spinal anaesthetic. Intravenous fentanyl was administered to all patients intraoperatively, with a mean of 115 micrograms. 5 patients required intraoperative alfentanil and morphine in the recovery area. 6 patients did not require oral opioids in the subsequent 24 hour period; the remainder of patients were administered a range of oral opioids from
2.5mg to 10mg (morphine or oxycodone). All patients had early mobilisation within 24 hours of surgery.
Conclusions Locally, the PENG block is a feasible alternative to fascia iliaca blocks, providing effective analgesia perioperatively and promoting early mobilisation. Further randomised controlled studies are required to examine the efficacy of PENG blocks in hip fractures.
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