Comparative Analysis of Pericapsular Nerve Group (PENG) Block Versus Femoral Nerve Block for Postoperative Pain Management in Total Hip Arthroplasty: An Observational Prospective Study

TL;DR

This study compares two nerve blocks for pain management after hip surgery, finding that the PENG block preserves motor function better than the femoral nerve block.

Contribution

The study provides new clinical evidence on the superior motor preservation of PENG blocks over FNB in total hip arthroplasty.

Findings

PENG block showed significantly higher knee extension motor scores compared to FNB.

PENG block resulted in higher leg adduction motor scores than FNB.

Both blocks were equally effective in reducing postoperative pain.

Abstract

Introduction: Total hip arthroplasty (THA) improves patient mobility and quality of life but is also associated with postoperative pain. Effective pain management is crucial for early postoperative mobility and optimal recovery. Regional analgesia techniques such as femoral nerve block (FNB) are commonly used, but recent studies suggest the pericapsular nerve group (PENG) block may provide superior hip analgesia with less motor impairment.

Objectives: This study compares the effectiveness of PENG block versus FNB concerning postoperative analgesia and motor block sparing in THA patients.

Materials and methods: An observational prospective study was conducted at the Unidade Local de Saúde da Região de Leiria, with data collected from January 2023 to April 2024. Patients aged 18 years or older undergoing primary THA and receiving either a PENG block or an FNB were included.

Results: A total of 55 patients (17 in the FNB group and 38 in the PENG group) participated in this study. Both blocks effectively reduced postoperative pain scores with no significant differences between groups, demonstrating their efficacy in pain management. Postoperative knee extension motor scores were significantly higher in the PENG group compared to the FNB group (1.52 vs. 1.17, p=0.036), indicating better preservation of motor function. Similarly, leg adduction motor scores were higher in the PENG group than in the FNB group (1.50 vs. 1.29, p=0.02).

Conclusion: The PENG block demonstrated superior motor function preservation and longer analgesia following THA compared to the FNB. The PENG block may offer a clinical advantage in facilitating earlier mobilization and improving overall recovery outcomes post-surgery.

Figures