Pericapsular Nerve Group Block: An Excellent Option for Analgesia for Positional Pain in Hip Fractures

Utsav Acharya, Ritesh Lamsal, Utsav Acharya, Ritesh Lamsal

Abstract

Fractures in and around the hip are common presentations in the emergency department. It is commonly seen in the elderly as a result of osteoporotic changes. However, younger age groups are also affected, especially as a result of high velocity trauma. Irrespective of age, hip fractures are extremely painful, and it is difficult to position the patients for anesthesia procedures. Most of these cases are performed under subarachnoid block (SAB) or combined spinal-epidural anesthesia (CSEA), which requires the patient to be in sitting or lateral position. Here, we report a series of ten cases where pericapsular nerve group (PENG) block was administered prior to positioning the patients for SAB or CSEA. This block is a recently described regional anesthesia technique that provides excellent analgesia for hip fractures. It also provides very good analgesia for patient positioning during procedures such as SAB or CSEA.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Copyright © 2020 Utsav Acharya and Ritesh Lamsal.

Figures

Figure 1
Figure 1
Relevant sonoanatomy for PENG block (F.A. = femoral artery; F.V. = femoral vein; AIIS = antero inferior iliac spine).
Figure 2
Figure 2
Local anesthetic spread after PENG block (L.A. = local anesthetic; F.A. = femoral artery; AIIS = antero inferior iliac spine).
Figure 3
Figure 3
Patient with left intertrochanteric femur fracture sitting upright for spinal anesthesia after administration of PENG block.
Figure 4
Figure 4
An 85-year-old lady with right intertrochanteric femur fracture maintaining upright sitting position without support after administration of PENG block.

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Source: PubMed

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