Comparison of pericapsular nerve group (PENG) block with fascia iliaca compartment block (FICB) for pain control in hip fractures: A double-blind prospective randomized controlled clinical trial

Mosaffa, Faramarz; Taheri, Mohammad; Rasi, Alireza Manafi; Samadpour, Hamidreza; Memary, Elham; Mirkheshti, Alireza

doi:10.1016/j.otsr.2021.103135

Cited by 48 publications

(69 citation statements)

References 13 publications

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“…Although, they did not find any significant difference in pain scores at other time points. A study carried out by Mosaffa et al [ 13 ] found insignificant difference in pain scores between PENG block and FIB in early postoperative period although pain score was found significantly lower among patients in PENG group at 12 h when compared with FIB, 3.01 (1.08) vs. 3.91 (1.48), p=0.021. Pascarella et al [ 10 ] reported that maximum numeric rating score of pain in PENG block was significantly lower when compared with patients in no block cohort at all-time points after surgery (p<0.001).…”

Section: Reviewmentioning

confidence: 94%

“…Mosaffa et al [ 13 ] in their study reported that the time to first request analgesia in PENG group was significantly lengthier when compared with patients in FIB group, 4.7 +3.1 vs. 2.58 + 2, (p=0.007). Pascarella et al [ 10 ] indicated that time to first request analgesia in PENG block group was 6 h longer than the control group, 12+6.7 vs. 6+4.9 (p=0.001).…”

Section: Reviewmentioning

confidence: 99%

“…Lin et al [ 14 ] were also unable to find any statistically significant difference in 24 h opioid consumption between PENG block and FN block (p=0.59). Mosaffa et al [ 13 ] indicated a significant difference in 24 h opioid consumption between PENG block as compared to FIB, 54 + 25.67 vs. 74.37 +18.87 mg, p=0.008. Pascarella et al [ 10 ] also reported a significant difference in 24 h morphine-equivalent opioid consumption between PENG block and no block group, 4 + 4.5 vs. 8.9 + 4 mg (p<0.001).…”

Section: Reviewmentioning

confidence: 99%

“…Lin et al [ 14 ] utilized 20 mL of 0.75% ropivacaine for PENG block prior to induction of anesthesia. In the study by Mosaffa et al [ 13 ], 3 mL/kg of 0.5% ropivacaine was used for the block pre-induction. PENG block was carried out after spinal anesthesia and prior to surgical incision using 20 mL of 0.375% ropivacaine in the study by Pascarella et al [ 10 ].…”

Section: Reviewmentioning

confidence: 99%

“…Secondly, type of anesthesia used in different studies was also different. General anesthesia was used in studies carried out by Scanaliato et al [ 15 ] and Zheng et al [ 12 ] while spinal anesthesia was performed in studies conducted by Aliste et al [ 6 ], Mosaffa et al [ 13 ], and Pascarella et al [ 10 ]. In the study by Lin et al [ 14 ], both anesthesia types were used depending on discretion of primary anesthesia team.…”

Section: Reviewmentioning

confidence: 99%

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The Use of Pericapsular Nerve Group (PENG) Block in Hip Surgeries Is Associated With a Reduction in Opioid Consumption, Less Motor Block, and Better Patient Satisfaction: A Meta-Analysis

Huda

Ghafoor

2022

Cureus

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Pericapsular nerve group (PENG) block has been successfully utilized as an optional regional anesthesia approach to manage the pain for hip surgeries without affecting motor function. During recent years, the applications of PENG block are expanding. There is one previous review on PENG block for hip surgeries in the scientific literature and it is limited to case series and case reports only. We found few randomized controlled trials related to the role of PENG block in recent literature. So, a meta-analysis was done to evaluate the role of PENG block in managing postoperative pain after hip surgeries. We followed PRISMA guidelines to perform this meta-analysis. Online databases including Medline and ScienceDirect were used. This review was registered with the PROSPERO database (CRD42022297694) in January 2022. The included studies in this review reported opioid use, pain control after surgery, and side effects associated with PENG block among patients undergoing hip surgeries. The Review Manager software, i.e. RevMan for Mac 5.4 (Cochrane Collaboration, Oxford, UK) was utilized to conduct a meta-analysis. During this meta-analysis, six randomized trials were included. Our results demonstrated that PENG block usage for patients undergoing hip surgery is correlated with a significant reduction in opioids in the first 24 h after surgery (p=0.05). It also resulted in significant prolongation of time to first request analgesia with mean difference as 3.82 h (0.05-7.60), (p=0.05). Our results showed that PENG block is associated with better patient satisfaction as well. The PENG block resulted in less motor block in the postoperative period (p=0.0002). In conclusion, PENG block can significantly reduce 24-h opioids consumption after hip surgery. This block also resulted in prolonged time to first request of analgesia postoperatively. There is less risk of motor block and hence the potential for better physiotherapy.

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Section: Reviewmentioning

confidence: 94%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

See 3 more Smart Citations

The Use of Pericapsular Nerve Group (PENG) Block in Hip Surgeries Is Associated With a Reduction in Opioid Consumption, Less Motor Block, and Better Patient Satisfaction: A Meta-Analysis

Huda

Ghafoor

2022

Cureus

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Does pericapsular nerve group block have limited analgesia at the initial post-operative period? Systematic review and meta-analysis

Farag

Diab

2022

J Anesth

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Perioperative pain management related to hip surgical procedures is challenging. Pericapsular nerve group (PENG) block is a novel technique that is assumed to provide better analgesia in addition to its post-operative motor-sparing effect. In this review, we aim to assess the safety and efficacy of PENG block on pain management in patients undergoing hip surgeries. Fifteen clinical trials with a total of 837 patients were included. Pain scores favored PENG group when compared to FICB group (fascia iliaca compartment block) or analgesics-only group, but the difference could only be detected in the early post-operative period. Afterward, it seems to lose its superiority, and no difference could be detected. In addition, cumulative opioid consumption favored PENG group at 24 h but not at 48 h. Regarding patients’ satisfaction, our analysis showed results favoring PENG group, but there was no difference in time to first opioid or length of hospital stay. The incidence of vomiting was lower in PENG, but there was no difference in the incidence of nausea, pruritis, and dizziness. PENG provides better analgesia and lower opioid consumption in the initial post-operative period. Current evidence is not enough, and further high-quality randomized controlled trials with larger sample sizes are required.

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Use of Peripheral Nerve Blocks for Total hip Arthroplasty

Grinman,

Elmore,

Ardon

et al. 2024

Curr Pain Headache Rep

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Purpose of Review The purpose of this review is to summarize the recent literature regarding regional anesthesia (RA) techniques and outcomes for total hip arthroplasty (THA) in the face of changing surgical techniques and perioperative considerations. Recent Findings Based on large meta-analyses, peripheral nerve blocks are indicated for THA. Each block has its own risks and benefits and data for outcomes for particular techniques are limited. Summary New surgical techniques, improved use of multimodal analgesia, and improved ultrasound guided regional anesthetics lead to better pain control for patients undergoing THA with less associated risks. Block selection continues to be influenced by provider comfort, surgical approach, patient anatomy, and postoperative goals. Head-to-head studies of particular nerve blocks are warranted.

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Comparison of pericapsular nerve group (PENG) block with fascia iliaca compartment block (FICB) for pain control in hip fractures: A double-blind prospective randomized controlled clinical trial

Cited by 48 publications

References 13 publications

The Use of Pericapsular Nerve Group (PENG) Block in Hip Surgeries Is Associated With a Reduction in Opioid Consumption, Less Motor Block, and Better Patient Satisfaction: A Meta-Analysis

The Use of Pericapsular Nerve Group (PENG) Block in Hip Surgeries Is Associated With a Reduction in Opioid Consumption, Less Motor Block, and Better Patient Satisfaction: A Meta-Analysis

Does pericapsular nerve group block have limited analgesia at the initial post-operative period? Systematic review and meta-analysis

Use of Peripheral Nerve Blocks for Total hip Arthroplasty

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