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.

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Background and Aims: The Surgical Pleth Index (SPI) is a multivariate index derived noninvasively from finger plethysmographic signal. It has been demonstrated to correlate with surgical stress intensity. So, we examined these beneficial effects of SPI guided anaesthesia to determine the amount of intraoperative fentanyl consumption and haemodynamic stability in laparoscopic surgeries under general anaesthesia. Methodology: After obtaining institutional ethical clearance and patient informed consent, A total of 100 Patients (20-65yrs) posted for laparoscopic surgeries under general anaesthesia were randomly allocated to the SPI and conventional analgesia group (50 patients each). In SPI group, SPI value >50; In conventional group, rise in heart rate(HR), mean arterial pressure (MAP) 20% above baseline were the criteria for fentanyl administration. Fentanyl 0.5 µg/kg is administered in each group for an event persisting for 5 min. Intraoperative fentanyl consumption, hemodynamic stability and postoperative pain for 1 hour were observed. Comparison analysis was performed for total intraoperative fentanyl consumption using t-test. Correlation analysis performed using the Pearson test and p-value <0.05 was considered significant. Results: Total intraoperative fentanyl consumption was lower in SPI group than in the conventional group (108.30±21.84 µg vs 125.70±24.87 µg; p=0.0003) and it was statistically significant with good haemodynamic stability. Postoperative pain scores were comparable in both the groups. The postoperative fentanyl consumption in SPI group was 14.4 ± 1.7 µg and in conventional group was 19.4± 7.0 µg. Conclusion: Compared with conventional analgesia, SPI guided analgesia resulted in lower intraoperative fentanyl consumption and more stable haemodynamics.