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21KF-016
Pericapsular nerve group block versus supra-inguinal fascia iliaca block for analgesia following Total hip arthroplasty

Do-Hyeong Kim,M.D., Ph.D.1, Ji Yeong Kim, M.D.2, Myeong Eun Jeong M.D.3


Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

Background: The optimal regional analgesic technique for total hip arthroplasty (THA) has not been established. This randomized controlled trial compared the effects of the pericapsular nerve group (PENG) block and supra-inguinal fascia iliaca compartment block (FICB) on postoperative analgesia and quadriceps strength following THA.

Methods: Fifty-eight patients undergoing THA under general anesthesia were randomized to receive either PENG block (PENG group) or supra-inguinal FICB (FICB group) following anesthetic induction. The primary outcome was pain score at rest 6 hours postoperatively. Pain scores at rest and with movement were assessed preoperatively, at the post-anesthesia care unit (only at rest), and 6, 24, 36, and 48 hours postoperatively. Opioid consumption was also assessed for 48 hours postoperatively. Quadriceps strength measurements were performed preoperatively, at 6, 24, and 36 hours postoperatively.

Results: Fifty-four patients completed the study: 27 in the PENG group and 27 in the FICB group. Pain score at rest was significantly lower in the PENG group at 6 hours postoperatively than in the supra-inguinal FICB group, even after adjusting for imbalanced variables among patient and operation characteristics. Opioid consumption and quadriceps strength were not significantly different between the two groups.

Conclusions: PENG block provided better analgesia during the early postoperative period than supra-inguinal FICB following THA. However, further studies are needed to determine the optimal dose and volume of local anesthetic for single-shot motor-sparing PENG block.