Pericapsular Nerve Group Block Versus Femoral Nerve Block for Analgesia in Newly Admitted Patients With Hip Fractures: A Randomized Controlled Trial.
Wen Liu, Xudong Zhang, Jianfen Zheng et al.
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In 30 seconds
This randomized controlled trial compared preoperative pericapsular nerve group (PENG) block with femoral nerve block (FNB) in 60 newly admitted patients with hip fractures. At 30 minutes, pain scores at rest and with passive movement were lower after PENG than after FNB: 0.0 [0.0, 1.2] vs. 1.1 [0.6, 1.8] at rest, and 2.9 [1.7, 3.6] vs. 3.4 [2.7, 4.7] with movement. By 12 hours, scores were higher with PENG, which was also associated with earlier rescue analgesia and greater 24-hour rescue analgesic use.
Key findings
- At 30 minutes, resting VAS was 0.0 [0.0, 1.2] with PENG versus 1.1 [0.6, 1.8] with FNB (P =0.020).
- At 30 minutes, passive movement VAS was 2.9 [1.7, 3.6] with PENG versus 3.4 [2.7, 4.7] with FNB (P =0.027).
- At 12 hours, resting and movement VAS scores were higher with PENG than FNB; PENG recipients also needed rescue analgesia sooner and in greater total doses within 24 hours (all P <0.001).
- Optimal ultrasound imaging was achieved faster with PENG; procedure duration, vital signs, and recovery quality did not differ significantly.
Why it matters
The comparison highlights a trade-off in regional analgesia for hip fracture: PENG provided better early pain scores and faster ultrasound imaging, but its analgesic effect appeared less sustained than FNB. The later pain scores and greater rescue analgesic requirements are relevant when assessing analgesia across the preoperative period, rather than relying only on early postblock pain relief.
What to keep in mind
The trial included 60 patients, and the abstract does not report longer-term outcomes.