Effect of pericapsular nerve group block versus femoral nerve block for optimal patient positioning during spinal anaesthesia in hip surgeries- A randomized concurrent parallel study

Authors: Dr. Logesh Ravichandran, Dr. Shanmugavalli Ettiyan, Dr. Suresh Rajkumar, Dr. Ezhilrajan Vaithiyalingam

DOI: 10.18231/j.ijca.10963.1760344738

Keywords: Pericapsular nerve group block, Femoral nerve block, Spinal Anesthesia positioning

Abstract: Aim and objective: This study aims to evaluate the efficacy of the pericapsular nerve group (PENG) block versus the femoral nerve block (FNB) for optimizing patient positioning during spinal anesthesia in hip surgeries. Introduction: Hip fractures pose considerable difficulties in managing pain and positioning patients during spinal procedures and anaesthesia. This study compares the efficacy of the pericapsular nerve group (PENG) block versus the femoral nerve block (FNB) for optimizing patient positioning during spinal anesthesia in hip surgeries. Material and Methods: This randomized, double-blinded, concurrent parallel study included 80 patients undergoing hip fracture surgeries. Patients were randomly allocated to receive either a PENG block or FNB with 20 mL of 0.25% bupivacaine. Pain was assessed using the VAS before and after the block, and at 15- and 30-minutes post-block. Primary outcomes were VAS pain scores during positioning and the number of assistants required. Secondary outcomes included time to perform spinal anesthesia, duration of analgesia, postoperative analgesic requirements, early mobilization, complications, and patient satisfaction. Result: The PENG block group demonstrated significantly lower VAS scores at 15- and 30-minutes post-block and during positioning for spinal anesthesia (p<0.01). The PENG group also required less time for spinal anesthesia block administration (p<0.001), had a longer duration of analgesia (p<0.001), needed less postoperative analgesia (p<0.001), and achieved early mobilization (p<0.001) compared to the FNB group. Patient satisfaction was higher, and the assistants required for positioning the patients for spinal was lower in the PENG group (p<0.01). Conclusion: The PENG block provides superior and longer-lasting analgesia compared to the FNB, enhancing patient comfort, streamlining clinical practice, and improving patient outcomes in hip surgeries