Pericapsular Nerve Group (PENG) Block versus Supra-Inguinal Fascia Iliaca Compartment Block for Total Hip Arthroplasty: A Randomized Clinical Trial

Yong Seon Choi, Kwan Kyu Park, Bora Lee, Won Seok Nam, Do-Hyeong Kim, Yong Seon Choi, Kwan Kyu Park, Bora Lee, Won Seok Nam, Do-Hyeong Kim

Abstract

This study compared the effects of the pericapsular nerve group (PENG) block and supra-inguinal fascia iliaca compartment block (FICB) on postoperative analgesia and quadriceps strength following total hip arthroplasty under general anesthesia. A total of 58 patients were randomized to receive either PENG block (PENG group) or supra-inguinal FICB (FICB group) following anesthetic induction. The primary outcomes were the postoperative pain scores. Patients were randomized to receive either PENG block or supra-inguinal FICB following anesthetic induction. Pain scores at rest and with movement were assessed preoperatively, at the postanesthesia care unit (only at rest), and at 6, 24, 36, and 48 h postoperatively. Opioid consumption was also assessed for 48 h postoperatively. Quadriceps strength measurements were performed preoperatively, at 6, 24, and 36 h postoperatively. In total, 54 patients completed the study: 27 in the PENG group and 27 in the FICB group. Despite lower pain scores at rest in the PENG group at postoperative 6 and 24 h, there were no significant differences in the pain scores at rest and during movement between the two groups during postoperative 48 h in the linear mixed model analysis (p = 0.079 and p = 0.323, respectively). Cumulative opioid consumption up to postoperative 48 h was also similar in the two groups (p = 0.265). The changes in quadriceps strength measurements in the operative leg and the nonoperative leg were not significantly different between the groups (p = 0.513 and p = 0.523, respectively). The PENG block may have similar analgesic efficacy to the supra-inguinal FICB. No difference was detected in the quadriceps strength between the patients receiving these two blocks.

Keywords: arthroplasty; hip surgery; nerve block; postoperative analgesia.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pericapsular nerve group (PENG) block: AIIS, anterior inferior iliac spine; IPE, iliopubic eminence; PT, psoas tendon.
Figure 2
Figure 2
Flow diagram of patient selection: ASA, American Society of Anesthesiologists; FICB, supra-inguinal fascia iliaca compartment block; PCA, patient-controlled analgesia; PENG, pericapsular nerve group block.
Figure 3
Figure 3
Pain intensity and opioid consumption: (A) NRS pain scores at rest over time. Data are expressed as mean ± standard deviation; (B) total opioid use over time. The bar chart displays the mean cumulative opioid consumption with standard deviation (error bars) at 6, 24, and 48 h following surgery. FICB, supra-inguinal fascia iliaca compartment block; NRS, numeric rating scale; PACU, postanesthesia care unit; PENG, pericapsular nerve group block.

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Source: PubMed

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