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Background and Aims Postoperative pain is a common concern associated with total hip arthroplasty (THA). We hypothesised that the concurrent administration of pericapsular (PENG) and parasacral (PS) sciatic block will result in superior postoperative analgesia in individuals undergoing THA. Our primary objective was to compare 24-hour opioid consumption. Secondary outcomes included 48-hour opioid consumption, Numerical Rating Scale (NRS) muscle strength (hip adductors, plantar flexors and quadriceps) and any adverse effect.

Methods Sixty 18 to 75 years old American Society of Anaesthesiologist (ASA) class I and II undergoing THR under general anaesthesia were randomised to receive: 20 mL of 0.2 percent ropivacaine in PENG block (Group P) or PENG and PS sciatic block (20 ml of 0.2%) in Group PS. Pain scores and muscle power (quadriceps, hip adductors and plantar flexors) were measured at 1,4,8,12,24 and 48 hours. Fentanyl consumption was measured at 24 and 48 hours post-operatively.

Results The mean 24 and 48-h fentanyl consumption was statistically more in Group P. Resting and Dynamic NRS scores were lesser in Group PS at all time intervals. Quadriceps muscle power at different time intervals reveal no statistically significant difference. Plantar flexor strength was more in Group P at 1 hour and 4 hour while hip adductor strength was more at 1 hour.

Conclusions Adding a PS sciatic nerve block to PENG block increases its analgesic efficacy with decrease in muscle power at 1 and 4 hours. Further randomised trials are needed to confirm our findings.