Table 1

Summary of literature of PENG block for hip pain

First author, publication date, country (reference)Type of reportSettingNumber of patientsInterventionAdditional nerve blocks used
PENG block in isolation for analgesia
 Giron-Arango L, Nov-18, Canada5 Case seriesHip fracture analgesiaFive adultsPENG block with either 20 mL of 0.25% bupivacaine with 1:400 000 epinephrine or 20 mL of 0.5% ropivacaine with 1:200 000 epinephrine plus 4 mg dexamethasoneNone
 Mistry T, Mar-19, India7 Case seriesHip fracture analgesiaFive adultsPENG block (local anesthetic solution not specified)None
 Yu HC, May-19, Canada8 Case reportHip fracture surgeryTwo adultsPENG block with either 20 mL 0.25% or 0.5% bupivacaine and 1:400 000 epinephrine+50 mcg/mL dexamethasoneNone
 Roy R, Jun-19, India9 Case seriesHip fracture surgeryFive patients initially—age not statedPENG block—local anesthetic solution not describedNone
 Rocha Romero A, Jun-19, Costa Rica10 Case reportHip fracture analgesiaOne adultPENG block with neurolytic injection of 10 mL of 6% phenolNone
 Ueshima H, Sep-19, Japan11 Case reportHip arthroplastyTwo adultsPENG block with 20 mL of 0.25% levobupivacaineNone
 Acharya U, Mar-19, Nepal12 Case seriesHip fracture analgesiaTen adultsPENG block with 20 mL 0.125% bupivacaine and 4 mg dexamethasoneNone
 Ahiskalioglu A, Nov-19, Turkey13 Case reportHip fracture analgesiaOne adultPENG block with 15 mL O.5% bupivacaine and 15 mL 2% lignocaineNone
 Bilal, Jan-20, Turkey14 Case reportHip fracture surgeryTwo adultsPENG block with 30 mL 0.25% bupivacaineNone
 Aksu C, May-20, Turkey15 Case reportOpen reduction congenital hip dysplasiaOne pediatricPENG block with 10 mL 0.25% bupivacaineNone
 Santos O, Jun-19, Portugal16 Case reportHip arthroplastyOne adultPENG block with 20 mL 0.5% ropivacaine and 4 mg dexamethasoneNerve catheter - additional 15 mL 0.5% ropivacaine intra-operatively+5 mL/hour 0.2% ropivacaine for 48 hours
PENG block in combination with local anesthetic infiltration for analgesia
 Sandri M, Mar-2020, Italy17 Case seriesHip arthroplastyTen patientsPENG block preoperatively with 40 mL 0.25% levobupivacaine and 4 mg dexamethasone10 mL 1% mepivacaine at surgical incision site
 Fusco P, Apr-19, Italy18 Case seriesHip arthroplastyFour patientsPENG block preoperatively with 20 mL solution containing 0.375% levobupivacaine and 4 mg dexamethasoneNone
PENG block in combination with LFCN block for analgesia
 Roy R, Jun-19, India9 Case seriesHip fracture surgeryFive later patients—age not statedPENG block—local anesthetic solution not describedLFCN block—local anesthetic solution not described
 Reza PC, Jan-20, Spain19 Case seriesHip arthroplasty, acetabular fracture surgerySeven patientsPENG block with 20 mL 0.375% bupivacaineLFCN block—5 mL 0.375% bupivacaine
 Thallaj A, Oct/Dec-19, Saudi Arabi20 Case reportHip arthroplastyOne adultPENG block with 30 mL 0.25% bupivacaineLFCN block with 5 mL 0.25% bupivacaine
PENG block in combination with femoral nerve block for analgesia
 Orozco S, Apr-19, Colombia21 Case seriesHip arthroscopyFive adultsPENG block preoperatively with 20 mL of 0.75% bupivacaine and 1% lignocaineFNB with 20 mL of 0.75% bupivacaine+1% lignocaine
PENG block in combination with LFCN block and femoral nerve block for analgesia
 Orozco S, Apr-19, Colombia22 Case reportHip surgery—osteosynthetic material retrievalOne pediatricPENG block with 10 mL 0.5% bupivacaineFNB with 15 mL 1% lignocaine/0.75% levobupivacaine and LFCN block with 5 mL 1% lignocaine/0.75% levobupivacaine
PENG block in combination with lumbar erector spinae block for analgesia
 Ince, I, Jan-20, Turkey23 Case reportCongenital hip dislocation surgeryOne pediatricPENG block with 8 mL 0.25% bupivacaineLumbar erector spinae plane block with 12 mL 0.25% bupivacaine
 Ince I, Jan-20, Turkey24 Case seriesHip arthroplastyThree adultsPENG block with 10 mL 0.5% bupivacaine and 10 mL 2% lignocaineLumbar erector spinae plane block with 30 mL 0.25% bupivacaine
PENG block as a sole anesthetic technique for analgesia
 Ueshemia H, Sep-19, Japan25 Case reportReduction of hip dislocationTwo adultsPENG block with 10 mL of 1% lignocaineNone
First author, publication date, country (Reference)Local anesthetic infiltrationOutcomes—analgesic efficacyOutcomes—adverse effectsComparison group
PENG block in isolation for analgesia
 Giron-Arango L, Nov-18, Canada5 NAReduction in NRS pain scores at rest (median reduction 7) and on movement at 30 minNone reportedCompared with patients pre-PENG block pain scores
 Mistry T, Mar-19, India7 NAAll patients reported dynamic pain relief after 10–15 min without any motor weaknessNone reportedNone
 Yu HC, May-19, Canada8 NAAdditional opioids required for postoperative analgesia in both patientsDescription of 2 patients who experienced motor weakness post PENG block attributed to incorrect needle positioningNA
 Roy R, Jun-19, India9 NAA few patients required rescue opioids for dermatomal painNone reportedAuthors describe that in their experience PENG block provides satisfactory reduction in pain for hip surgeries compared with other blocks available
 Romero A, Jun-19, Costa Rica10 NAComplete analgesia, no motor blockNone reportedNA
 Ueshemia H, Sep-19, Japan11 NAAdditional analgesics not required, uneventful perioperative course, no clear description of pain outcomes/analgesic medicationsNone reportedNA
 Acharya, U. Mar-19, Nepal12 NAMarked reduction in NRS pain scores when compared with pre-block, able to self-position for sitting spinal anesthesia in 9/10 cases with mild pain only on movement, able to sit without support post blockNone reportedCompared with patients pre-PENG block NRS pain scores
 Ahiskalioglu A, Nov-19, Turkey13 NAVAS preprocedure 9 at rest, at 10 min post-PENG block 1 at rest, on movement 2None reportedCompared with patients pre-PENG block pain scores
 Bilal, Jan-20, Turkey14 NAMaximum post-operative pain score during first 24 hours 3/10.No postoperative opioids requiredNone reportedNA
 Aksu C, May-20, Turkey15 NASingle-dose Ibuprofen 10 hours postoperatively, no additional analgesia requiredNone reportedNA
 Santos O, Jun-19, Portugal16 NAAt 8 hours pain 2/10 at rest and 2/10 on movement. At 24 hours and 48 hours pain 0/10 at rest and 0/10 on movement with no further analgesia requiredNone reportedNA
PENG block in combination with local anesthetic infiltration for analgesia
 Sandri M, Mar-2020, Italy17 YesAll 10 patients underwent surgery with 'light-moderate sedation', general anesthesia not required, maximal postoperative pain score reported 4/10, nil postoperative opioids requiredNone reportedNA
 Fusco P, Apr-19, Italy18 YesPain at rest on Numerical Rating Scale ‘two controls’, pain on movement ‘four controls’, patient reported lower perceived pain and ‘very satisfied’, no supplementary opioids/non-steroidal anti-inflammatory drugsNone reportedNA
PENG block in combination with LFCN block for analgesia
 Roy R, Jun-19, India9 NANo rescue opioids requiredNone reportedNA
 Reza PC, Jan-20, Spain19 NAPain outcomes not reported, only opioid consumption, 4 patients no opioids required postoperatively, 3 patients 6 mg or less intravenous morphine in first 24 hoursNone reportedNA
 Thallaj A, Oct/Dec-19, Saudi Arabi20 NAAnalgesia with paracetamol only postoperatively. 0–24 hours pain at rest 0/10, at 36 hours pain 2/10 at rest, at 48 hours pain 3/10 on movementNone reportedNA
PENG block in combination with femoral nerve block for analgesia
 Orozco S, Apr-19, Colombia21 NAHighest VAS in the 24 hours postoperatively 3/10, after 48–72 hours all patients none or very low levels of pain requiring no opioid analgesiaNone reportedNA
PENG block in combination with LFCN block and femoral nerve block for analgesia
 Orozco S, Apr-19, Colombia22 NA72 hours follow-up maximum pain score 2/10, no additional analgesia requiredNone reportedNA
PENG block in combination with lumbar erector spinae block for analgesia
 Ince, I, Jan-20, Turkey23 NAFLACC score maximum 1 for 24 hours follow-up. No postoperative opioids requiredNone reportedNA
 Ince I, Jan-20, Turkey24 NAHighest pain score in first 24 hours postoperatively 3/10, highest postoperative opioid consumption 8 mg intravenous morphine equivalentNone reportedNA
PENG block as a sole anesthetic technique
 Ueshima H, Sep-19, Japan25 NASuccessful reduction of hip dislocation in both patients without need for additional analgesia/anesthesiaNone reportedNA
  • FLACC, face legs, arms, cry, consolability pain scale; FNB, femoral nerve block; LFCN, lateral femoral cutaneous nerve; NA, not applicable; NRS, Numerical Rating Scale; PENG, pericapsular nerve group; VAS, Visual Analog Scale.