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Review
. 2023 Feb;12(1):81-92.
doi: 10.1007/s40122-022-00463-0. Epub 2022 Dec 8.

The Efficiency of Ultrasound-Guided Pericapsular Nerve Group Block for Pain Management after Hip Surgery: A Meta-analysis

Yi Wang #  1 , Huaichang Wen #  2 , Mengli Wang  2 , Meijing Lu  2
Affiliations
Review

The Efficiency of Ultrasound-Guided Pericapsular Nerve Group Block for Pain Management after Hip Surgery: A Meta-analysis

Yi Wang et al. Pain Ther. 2023 Feb.

Abstract

Introduction: Patients with hip surgery often experience moderate to severe postoperative pain, and need large doses of opioids to relieve it, which is not conducive to patient rehabilitation. Pericapsular nerve group (PENG) block is a new regional block technique that is considered to reduce postoperative pain and the use of opioids. The purpose of this study was to evaluate the efficacy and safety of PENG block for postoperative analgesia after hip surgery.

Methods: We searched multiple databases for randomized controlled trials (RCTs) published in English, which compared PENG block with fascia iliaca compartment block (FICB). The primary outcome was 24 h postsurgical opioid consumption (OC). The secondary outcomes were pain scores (PSs) at different timepoints after surgery and the incidence of postoperative nausea and vomiting (PONV).

Results: Five RCTs involving 234 patients were selected for our analysis. Our results show that the 24 h OC was drastically lower in PENG block versus FICB patients (SMD -0.60, 95% CI -1.08 to -0.11); P < 0.05, I2 = 69%). At the same time, there were no significant difference in postsurgical PSs between the two cohorts (6 h: MD -0.07, 95% CI -0.67 to 0.53; P = 0.82, I2 = 43%; 12 h: MD -0.60, 95% CI -1.40 to 0.19; P = 0.14, I2 = 31%; 24 h: MD 0.17, 95% CI -0.87 to 1.21; P = 0.75, I2 = 76%; 36 h: MD 0.80, 95% CI -0.92 to 2.51; P = 0.36, I2 = 73%; 48 h: MD -0.06, 95% CI -0.75 to 0.63; P = 0.86, I2 = 0%) and the incidence of PONV (RR 1.00, 95% CI 0.40-2.50, P = 1.00, I2 = 35%).

Conclusions: Our research shows that PENG block can reduce the use of opioids after hip surgery and is effective in postoperative analgesia. Future research should explore the injection method, concentration, and dosage.

Keywords: Hip surgery; Meta-analysis; Pericapsular nerve group block.

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Figures

Fig. 1
Fig. 1
The study selection process
Fig. 2
Fig. 2
Bias risks of analyzed investigations
Fig. 3
Fig. 3
Forest plot of pooled analysis depicting postsurgical opioid usage
Fig. 4
Fig. 4
Forest plot of pooled analysis illustrating the pain scores at various durations from surgery
Fig. 5
Fig. 5
Forest plot of pooled analysis depicting postsurgical nausea and vomiting incidences
See this image and copyright information in PMC

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