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ePoster session 1 – Station 4
EP022 Efficacy of PENG block over sedation during positioning in sub-arachnoid block for hemiarthroplasty of the hip: an observational study
  1. Golam Ferdous Alam1,
  2. Amandeep Sachdeva1,
  3. Priya Pathak2,
  4. Gaurav Kumar2,
  5. Muhammad Butt1 and
  6. Manish Bhardwaj3
  1. 1Specialist, Frimley Health NHS Foundation Trust, London, UK
  2. 2Clinical Fellow, Frimley Health NHS Foundation Trust, London, UK
  3. 3Consultant, Frimley Health NHS Foundation Trust, London, UK

Abstract

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

Background and Aims Pericapsular nerve group (PENG) block gathered good results for pain relief in hip fracture. We compared the efficacy of PENG block over sedation technique in positioning for sub-arachnoid block (SAB) in patients with intracapsular fracture neck of femur (NOF) for hemiarthroplasty.

Methods Sixteen patients in each group for hemiarthroplasty were consented for PENG block (Gr-A) and sedation (Gr-B) prior to SAB. Patients with mental obtundation and conditions contraindicated for SAB were excluded. Ultrasound guided PENG block with 20 ml of 0.25% of bupivacaine administered in Gr-A. SAB (hyperbaric bupivacaine 0.5% 2.2 ml) commenced in lateral position 10 minutes after PENG block with fracture side up. Sedation with fentanyl, midazolam and propofol were given in Gr-B prior to positioning for SAB. Visual analogue score (VAS) for pain along with ease of positioning were assessed during SAB.

Results Mean age (79 yrs) and M:F ratio were identical in both groups. All patients were noted VAS 10 on minimal hip abduction on arrival. VAS reduced to 2 (12pt), 3( 4pt) 10 minutes after PENG block in Gr-A on positioning for SAB. While 37.5%(6pt) of Gr-B required additional boluses of sedation due to VAS 8 and above during positioning for SAB. Successful SAB commenced in 100% patients in Gr-A compared to 87.5 in Gr-B. No pain was observed in Gr-A on returning to supine immediately after SAB compare to 10 pts in Gr-B.

Abstract EP022 Figure 1
Abstract EP022 Figure 1

Anatomy of PENG

Abstract EP022 Figure 2
Abstract EP022 Figure 2

Sono anatomy of PENG

Abstract EP022 Figure 3
Abstract EP022 Figure 3

Comparison of VAS score

Conclusions PENG block provide an effective analgesia in patients with intracapsular fracture NOF for positioning for SAB over sedation.

  • PENG Pericapsular nerve group
  • Gr Group
  • VAS Visual analogue scale
  • SAB: Sub-arachanoid block
  • NOF: Neck of femur.

https://doi.org/10.1136/rapm-2024-ESRA.95

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