Pericapsular nerve group block in hip arthroplasty: A prospective randomized trial

J Opioid Manag. 2023 Jul-Aug;19(4):313-320. doi: 10.5055/jom.2023.0788.

Abstract

Objectives: This study aimed to evaluate the analgesic effect of the ultrasound-guided pericapsular nerve group (PENG) block in hip arthroplasty (HA) surgery.

Design: A prospective double-blinded, randomized study.

Setting: Tertiary institutional clinical care.

Participants: Fifty patients, more than 50 years old of both genders, were chosen according to the American Society of Anesthesiologists classification, with physical status I-III, and scheduled for unilateral HA surgeries.

Interventions: Patients were randomized to receive either a sham PENG block with 20 mL of normal saline (control group) or a PENG block with 20 mL of bupivacaine 0.25 percent (PENG group).

Main outcome measures: From the onset of the first request for rescue opioid analgesia, preoperative pain scores before and after block (at rest and with a raised straight leg), the incidence of quadriceps weakness after the block, intraoperative fentanyl consumption, post-operative pain scores, and morphine consumption, besides the presence and frequency of adverse events, were recorded.

Results: The patients undergoing PENG block with bupivacaine had prolonged durations before the first analgesic request, lower perioperative pain scores, less intraoperative rescue fentanyl, and less post-operative morphine consumption than the control group, with nonsignificant motor weakness after the block and similar adverse events.

Conclusions: The PENG block provided effective perioperative analgesia for HA with prolonged duration of analgesia, nonsignificant motor effects, reduced perioperative opioids consumption, and no major side effects.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Anesthetics, Local* / adverse effects
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Bupivacaine / adverse effects
  • Female
  • Femoral Nerve
  • Fentanyl / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control
  • Prospective Studies

Substances

  • Anesthetics, Local
  • Analgesics, Opioid
  • Bupivacaine
  • Morphine
  • Fentanyl