Efficacy of Preoperative Pericapsular Nerve Group Block in Patients with Hip Fracture and its Effect on the Success of Spinal Anaesthesia: A Retrospective Study.

Abstract

Objective: We intended to research the efficacy of pericapsular nerve group (PENG) block performed with preoperative ultrasonography (USG) in patients who underwent hip fracture repair under spinal anaesthesia and whether it affects the success of spinal anaesthesia.

Methods: The files of 100 patients were analysed, and 60 patients were enrolled in the study. The patients were assigned into two groups: Group P (n = 30) consisted of patients who underwent USG-guided PENG block before the start of surgery and the control group (Group C; n = 30) consisted of patients in whom tramadol infusion was initiated. All patients received 10 mg IV bolus tramadol as rescue analgesia when numeric rating scale (NRS)>3. From the files of the patients, before PENG block application, after PENG block application, during positioning before spinal anaesthesia, the NRS values at the time of the patient's discharge from the operating room and at 2^nd, 4^th, 12^th and 24^th hour NRS values, spinal anaesthesia duration and number of attempts, and perioperative total tramadol consumption were obtained.

Results: In group P, NRS values were found to be significantly lower after PENG block application, during positioning before spinal anaesthesia, and at the postoperative discharge, 2^nd, 4^th, 12^th and 24^th hours. In addition, group P had a lower duration of spinal anaesthesia, a lower number of spinal anaesthesia attempts and a lower total perioperative tramadol consumption.

Conclusion: The results demonstrated that preoperative PENG block facilitated positioning for spinal anaesthesia, shortened the application time, increased the first-attempt success rate, decreased pain scores, and reduced the need for postoperative opioids.