Evaluation of Pericapsular Nerve Group (PENG) Block for Analgesic Effect in Elderly Patients with Femoral Neck Fracture Undergoing Hip Arthroplasty

Hao Hua, Yan Xu, MengLu Jiang, Xu Dai, Hao Hua, Yan Xu, MengLu Jiang, Xu Dai

Abstract

Background: For evaluating pericapsular nerve group (PENG) block's analgesic effect on elderly patients suffering from femoral neck fracture undergoing hip arthroplasty to provide a basis for optimizing perioperative analgesia in hip arthroplasty.

Methods: Forty-eight patients undergoing hip arthroplasty with spinal anesthesia for femoral neck fracture in our hospital were chosen in this study. Based on the random number table method, patients were categorized into the following two groups (n = 24 per group): the hip peripheral nerve group block group (PE group) and the iliac fascia block group (FI group). The fascia iliaca compartment block was used in the FI group, whereas the pericapsular nerve group block in the PE group. When placed in the position for spinal anesthesia (T4), we measured dynamic and static visual analog scale (VAS) scores as well as analgesic satisfaction before blockade (T0), along with at 10 min (T1), 20 min (T2), and 30 min postblockade (T3). Sufentanil dosage and effective analgesic pump press number at 6 h (T5), 12 h (T6), 24 h (T7), and 48 h (T8) postoperatively were recorded. In the meantime, the development of related complications was also recorded.

Results: Compared with T0, patients in both groups achieved lower static VAS scores at T1-T4 (P < 0.05) and lower dynamic VAS scores at T2-T4 of the FI group (P < 0.05). Relative to the FI group, both static and dynamic VAS scores at T1-T4 were obviously lower in the PE group (P < 0.05), along with increased dynamic analgesic satisfaction (P < 0.05). Weakness of the quadriceps was observed in seven patients in the FI groups (P < 0.05). No delirium, hematoma, puncture site infection, or nerve injury occurred in either group.

Conclusion: The pericapsular nerve group block can provide safe and effective analgesia for elderly patients during the perioperative period of hip arthroplasty, with rapid onset, good analgesic effect, high patient satisfaction, and low complication rate, and is worthy of widespread application. The trial is registered with ChiCTR2100046785.

Conflict of interest statement

All the authors declare that they have no conflicts of interest.

Copyright © 2022 Hao Hua et al.

Figures

Figure 1
Figure 1
An ultrasound image of the PENG block (white arrow). AIIS: anterior inferior iliac spine, FA: femoral artery, IPE: iliopubic eminence, and PE: pectineus muscle.
Figure 2
Figure 2
Consolidated Standards of Reporting Trials (CONSORT) flow diagram.
Figure 3
Figure 3
Trends in static (a) and dynamic (b) VAS scores of the two groups. Note: P < 0.05 compared with the PE group, label∗; P < 0.05 compared with T0, label #; VAS, visual analog scale; PE, pericapsular nerve group block group; FI, fascia iliaca compartment block group.
Figure 4
Figure 4
Static and dynamic VAS scores at T4 of the two groups. VAS, visual analog scale; PE, pericapsular nerve group block group; FI, fascia iliaca compartment block group. Note: P < 0.05 compared with T0, label #.
Figure 5
Figure 5
Static and dynamic satisfaction of the two groups. PE, pericapsular nerve group block group; FI, fascia iliaca compartment block group.
Figure 6
Figure 6
Trends in static (a) and dynamic (b) VAS scores of the two groups after surgery. PE, pericapsular nerve group block group; FI, fascia iliaca compartment block group.

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