Pericapsular nerves block (PENG) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: A randomized clinical trial

S L Iglesias; I Nieto; P López; A Almada; I Pioli; F Astore; C Rodríguez Urmenyi; B L Allende

doi:10.1016/j.recot.2022.12.004

Pericapsular nerves block (PENG) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: A randomized clinical trial

Rev Esp Cir Ortop Traumatol. 2023 May-Jun;67(3):226-232. doi: 10.1016/j.recot.2022.12.004. Epub 2022 Dec 16.

[Article in English, Spanish]

Authors

S L Iglesias¹, I Nieto², P López², A Almada², I Pioli², F Astore³, C Rodríguez Urmenyi³, B L Allende²

Affiliations

¹ Instituto Allende, Cirugía Reconstructiva de los Miembros, Servicio de Artroplastia y Trauma del Miembro Inferior, Sanatorio Allende, Córdoba, Argentina. Electronic address: santiglesias07@hotmail.com.
² Instituto Allende, Cirugía Reconstructiva de los Miembros, Servicio de Artroplastia y Trauma del Miembro Inferior, Sanatorio Allende, Córdoba, Argentina.
³ Servicio de Analgesia y Anestesia, Sanatorio Allende, Córdoba, Argentina.

PMID: 36529424
DOI: 10.1016/j.recot.2022.12.004

Abstract

Background: Postoperative pain after total hip arthroplasty can affect postoperative rehabilitation and delay hospital discharge. The objective of this study is to compare pericapsular nerves group (PENG) block with pericapsular infiltration (PAI) and plexus nerve block (PNB) for postoperative pain management, response to physical therapy, opioid consumption, and length of hospital stay after a primary total hip arthroplasty.

Methods: Randomized clinical trial of parallel and blinded groups was performed. Sixty patients who underwent elective THA between December 2018 and July 2020 were randomized into the different groups (PENG, PAI and PNB). The visual analog scale was used to assess pain; and motor function was measured with the Bromage scale. We also record opioid usage, length of hospital stay, and related medical complications.

Results: Pain level at discharge was similar in all groups. Hospital stay was 1 day shorter in the PENG group (p<0.001) and they also had lower opioid consumption (p=0.044). Optimal motor recovery was similar in the groups (p=0.678). Pain control when performing physical therapy was better in the PENG group (p<0.0001).

Conclusions: PENG block is an effective and safe alternative for patients undergoing THA as it reduces opioid consumption and hospital stay compared to other analgesic methods.

Keywords: Anestesia; Anesthesia; Artroplastia cadera; Cadera; Dolor; Hip; Hip arthroplasty; Nervios pericapsulares de cadera; Pain; Pericapsular nerves block.