Pericapsular Nerve Group Block Versus Femoral Nerve Block for Analgesia in Newly Admitted Patients With Hip Fractures: A Randomized Controlled Trial.

OBJECTIVES

To compare the effects of preoperative pericapsular nerve group (PENG) block versus femoral nerve block (FNB) on pain in patients with hip fractures.

METHODS

Sixty eligible patients were randomized (1:1) to receive PENG block or FNB. The primary endpoint was post-block pain assessed via Visual Analogue Scale (VAS). Secondary endpoints included time to optimal ultrasound imaging, procedure duration, time to first rescue analgesic, 24-hour rescue analgesic consumption, postoperative recovery quality, vital signs, and adverse events.

RESULTS

At 30 minutes post-block, both resting VAS scores (0.0 [0.0, 1.2] vs. 1.1 [0.6, 1.8], P=0.020) and passive movement VAS scores (2.9 [1.7, 3.6] vs. 3.4 [2.7, 4.7], P=0.027) were significantly lower in the PENG group compared with the FNB group. At 12 hours post-block, resting VAS (3.0 [2.1, 4.0] vs. 2.3 [1.7, 2.6], P=0.006) and passive movement VAS (6.8 [5.1, 7.3] vs. 4.9 [4.1, 5.8], P=0.002) were higher in the PENG group. The PENG group achieved optimal ultrasound imaging faster, had an earlier time to first rescue analgesic, and required a greater total dose of rescue analgesics within 24 hours (all P <0.001). Procedure duration, vital signs, and recovery quality did not differ significantly.

DISCUSSION: PENG blocks outperform FNB in imaging speed and early pain control but yield a shorter block duration, thereby increasing 24-hour rescue analgesic demands.