Background and Aims Postoperative pain is a major concern in the patients undergoing Total Hip Arthroplasty. Peripheral nerve blockades have started gaining attention in the recent past for arthroplasty. Supra-inguinal fascia iliaca block (FIB) has become the standard of care at many places. Lately, (PENG) block has been proved to be safe and effective.

To compare the analgesic efficacy of USG guided Pericapsular nerve group block (PENG) with Supra-inguinal fascia iliaca block (SIFIB) in THR under General Anesthesia (GA).

Methods After IEC clearance, 18 patients scheduled to undergo THR under GA were included in this double blinded, randomized controlled trial.

Group I received PENG and Group II received SIFIB block with 0.25% bupivacaine and 1mcg/kg clonidine respectively. The primary outcome was 24 hr morphine consumption. Secondary outcomes were Intraoperative opioid consumption, Mean Numerical rating scale (NRS: 0–10) in 24 hr. and adverse effects.

Results Baseline demographics were similar. The mean 24-hour morphine(mg) consumption in Group I(PENG) was 10.44±1.94 mg and 12.22±1.85 mg in Group II(SIFIB) with p value=0.065. Intraoperative Fentanyl consumption(mcg) in PENG was 51.11± 9.28 and in SIFIB was 67.78±12.02 with p value = 0.005 which is statistically significant. Median of Mean NRS of 24 hr was 2.63± 0.44 in PENG and 3.31± 0.62 in SIFIB.

Conclusions Patients receiving PENG block required less intraoperative opioid. The postoperative 24-hour morphine consumption though not statistically significant but could be clinically significant. Also, PENG group experienced less pain comparing to SIFIB group. Two patients experienced vomiting in the SIFIB group.

IEC Clearance obtained with reference number: AIIMS/Pat/IEC/PGTH/July19/22.