Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims Ultrasound-guided Pericapsular Nerve Group (PENG) block is an emerging regional anesthesia technique for patients undergoing hip surgeries. PENG blocks target the articular sensory branches of the hip capsule and it is thought to spare the motor branches. This review evaluates the analgesic efficacy and effectiveness of PENG block in patients undergoing hip surgeries.

Methods We conducted a meta-analysis of randomized controlled trials (RCTs) in patients undergoing hip surgeries where PENG block was compared to no block, placebo, or other analgesic techniques. Our primary outcome is the postoperative opioid consumption during the first 24 hours. Secondary outcomes were postoperative rest and dynamic pain scores at 6-12, 24 and 48 hours, sensory motor assessment, quadriceps weakness, incidence of postoperative falls, first analgesic request, PACU and hospital length of stay, functional outcomes, and persistent post-surgical pain.

Results We analyzed 24 RCTS with a total of 1474 patients. There is moderate quality of evidence to suggest that PENG block decreased 24 hour morphine consumption by a mean difference (MD) of 2.54mg (95% CI: -3.69, -1.40). The greatest difference was found when PENG block was compared to sham/no block. However, after adjusting for publication bias, the MD decreased to 1.05mg (95%CI: -2.25, 0.15).

Conclusions Our meta-analysis regarding the use of PENG block for analgesia in hip surgeries suggests that there was minimal difference with no clinical significance in the first 24 hours after hip surgery but the reduction of morphine milliequivalent was seen more in total hip arthroplasty cohorts than in hip fracture patients.