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. 2024 Dec 1;36(4):290-301.
doi: 10.5371/hp.2024.36.4.290.

Comparison of Analgesic Efficacy between Ultrasound-guided Supra-inguinal Fascia Iliaca Block and Pericapsular Nerve Group Block following Total Hip Arthroplasty: A Randomized Controlled Trial

Chutikant Vichainarong  1 , Wirinaree Kampitak  1 , Srihatach Ngarmukos  2   3 , Aree Tanavalee  2   3 , Chotetawan Tanavalee  2   3 , Pongkwan Jinaworn  1
Affiliations

Comparison of Analgesic Efficacy between Ultrasound-guided Supra-inguinal Fascia Iliaca Block and Pericapsular Nerve Group Block following Total Hip Arthroplasty: A Randomized Controlled Trial

Chutikant Vichainarong et al. Hip Pelvis. .

Abstract

Purpose: The effectiveness of pericapsular nerve group (PENG) block versus suprainguinal fascia iliaca block (SFIB) for pain relief after hip arthroplasty is a topic of ongoing debate. This study aimed to examine the association of PENG block with lower consumption of opioids during the first 24 hours following surgery compared to SFIB.

Materials and methods: In this single-center, double-blind, randomized controlled trial, 60 patients scheduled for an elective posterior approach to total hip arthroplasty (THA) were randomized according to two groups: ultrasound-guided PENG block (PENG group) or SFIB (SFIB group). The 24-hour consumption of intravenous fentanyl was the primary outcome. Secondary outcomes included perioperative consumption of intravenous fentanyl, pain scores, sensorimotor function, and functional measures.

Results: No significant intergroup difference was observed in 24-hour total fentanyl consumption (SFIB group: 117.4±99.8 μg, PENG group: 145.9±122.7 μg; mean difference: 22.6 μg [95% confidence interval -36.6 to 81.8]; P=0.45). No statistically significant difference in terms of fentanyl consumption in intraoperative, post-anesthetic care unit, at 6-hour and 48-hour postoperatively was observed between the two groups. No statistically significant differences in scores for rest and dynamic pain for all aspects of hip joint and surgical incision were observed between the groups (P>0.05). Better cutaneous sensory perception in the hip region and 12-hour postoperative quadriceps muscle strength at 90° were observed in the PENG group compared with the SFIB group (P<0.05).

Conclusion: Compared to SFIB, the addition of PENG block to multimodal analgesia did not reduce fentanyl consumption or pain scores after posterior approach THA.

Keywords: Nerve blockades; Peripheral nerves; Postoperative pain; Total hip arthroplasty; Ultrasound.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
CONSORT (Consolidated Standards of Reporting Trials) statement flow diagram. ASA: American Society of Anesthesiologists, NSAIDs: nonsteroidal anti-inflammatory drugs, SFIB: suprainguinal fascia iliaca block, PENG: pericapsular nerve group block, ITT: intention-to-treat.
Fig. 2
Fig. 2
Ultrasound image of PENG (A), suprainguinal fascia iliaca (B), and transversalis fascia plane (C) blocks. White lines indicate the direction of the needle for injection. PENG: pericapsular nerve group, FA: femoral artery, FN: femoral nerve, IM: iliac muscle, PT: psoas muscle tendon, IPE: iliopubic eminence, IOM: internal oblique muscle, DCIA: deep circumflex iliac artery, EOM: external oblique muscle, TAM: transversus abdominis muscle, QL: quadratus lumborum muscle.
See this image and copyright information in PMC

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