Comparison of pericapsular nerve group block versus supra-inguinal fascia iliaca block on postoperative pain management, quadriceps muscle strength, and early functional outcomes after arthroscopic treatment of femoroacetabular impingement: a prospective, randomized clinical study

TL;DR

This study found that pericapsular nerve group blocks improved postoperative pain, muscle strength, and recovery after hip surgery compared to another nerve block method.

Contribution

The study introduces evidence that PENG blocks are superior to FICB for postoperative outcomes in hip arthroscopy patients.

Findings

PENG group patients had better quadriceps strength and fewer postoperative falls compared to FICB group.

PENG group had significantly lower pain scores and opioid consumption in the first 24 hours post-surgery.

PENG group showed better functional outcomes at 6 and 12 months postoperatively.

Abstract

This study compared the effects of pericapsular nerve group (PENG) block and supra-inguinal fascia iliaca compartment block (FICB) on quadriceps strength, postoperative analgesia, and functional scores following hip arthroscopy (HA) for patient complaining of femoroacetabular impingement (FAI) under general anaesthesia. A prospective, randomized, and controlled trial recruited a total of 48 patients who had either PENG group or supra-inguinal FICB as a pain management modality. The primary outcomes were the postoperative quadriceps muscle power, and the secondary outcomes included pain scores, opioid consumption, and functional scores; the modified Harris hip score (mHHS) and international hip outcome tool-12 (iHOT-12) score. All patients in PENG group were capable of performing a straight leg raise with hip flexion of >15°. In contrast, two patients in FICB group had postoperative falls and six patients (25%) were unable to perform a straight leg raise at 24 h postoperatively. At the time of admission to the post-anaesthesia care unit and at 6, 12, and 24 h postoperatively, peak visual analogue scale (VAS) scores at rest were 6, 5, 4, and 4, respectively, in PENG group and 8, 7, 6, and 5, respectively, in FICB group (P < .001). Total opioid consumption in the 24 h postoperatively was lower in the PENG group compared to the FICB group (mean, 18.5 ± 9.4 versus 26.8 ± 9.6; P < .05). Significant improvement was observed (6 and 12 months postoperatively) regarding iHOT-12 score in the PENG group (70 ± 24.33, 82.85 ± 11.45) compared to the FICB group (59.04 ± 22.66, 64.1 ± 17.42) (P = .02, P < .001, respectively).

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