Anesthesia or analgesia? New block for shoulder surgery: pericapsular nerve group block

Abstract

Interscalene brachial plexus (ISB) block is considered the analgesic technique of choice for shoulder surgery. However, the hemidiaphragmatic paresis that may occur after the block has led to the search for an alternative to the ISB block. In this case report, the pericapsular nerve group (PENG) block was performed for both surgical anesthesia and postoperative analgesia in two patients who underwent shoulder surgery. It is suggested that the PENG block can be safely applied for analgesia and can be part of surgical anesthesia, but alone is not sufficient for anesthesia. The block of this area did not cause motor block or pulmonary complications, nor result in muscle laxity, blocking only the shoulder and the upper third of the humerus. It was demonstrated that the PENG block may be safely applied for both partial anesthesia and analgesia in selected shoulder surgery cases.

Keywords: Pericapsular Nerve Group Block (PENG); Postoperative analgesia; Regional anesthesia; Shoulder surgery.

Copyright © 2021. Published by Elsevier Editora Ltda.

Figures

Figure 1

Position of the US probe (A) and the needle (B). HH, humerus head; SSc Tn, subscapularis tendon; Deltoid, deltoid muscle.

Figure 2

Procedure of surgery.

Figure 3

Local anesthetic infiltration between the deltoid and the subscapularis tendon. HH, humerus head; SSc Tn, subscapularis tendon; deltoid, deltoid muscle.