A Retrospective Case Series of Pericapsular Nerve Group (PENG) Block for Primary Versus Revision Total Hip Arthroplasty Analgesia

Promil Kukreja, Audrey Avila, Theresa Northern, Jyoti Dangle, Sree Kolli, Hari Kalagara, Promil Kukreja, Audrey Avila, Theresa Northern, Jyoti Dangle, Sree Kolli, Hari Kalagara

Abstract

The innervation of the hip joint is complex and it is challenging to provide effective analgesia after hip surgery utilizing any single regional anesthesia technique. The pericapsular nerve group (PENG) block is an interfascial plane block aiming to block articular branches supplied by femoral, obturator, and accessory obturator nerves. In this case series, we compare the efficacy of the PENG block to provide analgesia in primary and revision total hip arthroplasty (THA). The ultrasound-guided PENG block technique is described and post-operative pain scores and opioid requirements are reported. The PENG block was successfully used in primary THA as a solo block, and it may be used in combination with other regional blocks for any hip surgery. The PENG block is an easy regional technique to perform in the supine position with motor-sparing benefits.

Keywords: hip analgesia; interfascial plane block; multimodal analesia; peng; pericapsular nerve block; total hip arthroplasty.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2020, Kukreja et al.

Figures

Figure 1. Ultrasound image of PENG block…
Figure 1. Ultrasound image of PENG block showing lateral to medial insertion of needle shown by black arrows passing the anterior inferior iliac spine (AIIS) and depositing the local anesthetic along the ilio-pubic eminence (IPE) lateral to the femoral artery (FA)
PENG: pericapsular nerve group.
Figure 2. Average pain scores of primary…
Figure 2. Average pain scores of primary versus revision hip arthroplasty patients after the pericapsular nerve group (PENG) block
Figure 3. Post-operative opioid use (OME) of…
Figure 3. Post-operative opioid use (OME) of primary versus revision hip arthroplasty patients after pericapsular nerve group (PENG) block

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