Comparison of Pericapsular Nerve Group Block with Fascia Iliaca Compartment Block in Adult Patients Undergoing Hip Surgeries: A Double-Blinded Randomized Control Study.

Abstract

Background: Hip fractures are the most common orthopedic condition in elderly patients. In this patient group, efficient preoperative analgesia that reduces the requirement for opioids and their negative side effects is crucial. This study aims for evaluating the efficiency of fascia iliaca compartment block (FICB) and pericapsular nerve group (PENG) in providing the appropriate analgesia before positioning patients for spinal anesthesia (SA).

Methods: Ninety participants undergoing hip surgeries under SA were selected randomly to receive PENG block (n = 45) using 20 mL 0.25% bupivacaine or FICB using 30 mL of 0.25% bupivacaine. The blinded observer assessed Visual Analog Scale (VAS) scores at rest, with passive leg raise to 15° before and after 30 min of the block. The blinded observer also recorded hemodynamic parameters including noninvasive blood pressure respiratory rate and heart rate. The data were analyzed using SPSS version 19. Using the appropriate statistical methodology, continuous and categorical data were analyzed, and P ≤ 0.05 was considered statistically significant.

Results: At rest and with a passive leg raise to 15°, VAS scores in the PENG and FICB groups decreased significantly (P < 0.0001). After 30 minutes of performing the PENG block, the VAS scores at rest and passive leg raise were 2.16±0.67 and 3.29±0.73 respectively, whereas with the fascia iliaca block the VAS scores at rest and passive leg raise were 4.07±0.69 and 5.11±0.71 with the p = 0.001, which is highly significant.

Conclusion: PENG block outperforms fascia iliaca block in providing effective analgesia before positioning patients undergoing hip surgery under SA.