Preliminary results of comparative analysis of peri-capsular nerve group block versus fascia iliaca block for hip arthroplasty

Still the best regional anaesthetic block in hip arthroplasty is not known. Femoral nerve and fascia iliaca (FI) blocks do not cover obturator nerve. Pericapsular Nerve Group (PENG) block is new approach which blocks articular branches to the hip including obturator nerve. We compared the efficacy of PENG and FI blocks in hip surgeries. In preliminary analysis data of prospectively included 14 patients undergoing hip arthroplasty in Riga East University Hospital were analysed. All patients received standard general anaesthesia combined with FI block (FI group, n=5), PENG block (PENG group, n=6) or without block (Control group, n=3). At the end of surgery PENG or FI block with Bupivacaine 0.5%-20ml and Epinephrine 200 mkg was performed. Pain intensity assessed by numerological pain score (NPS) 1, 8 and 24 hours after surgery was recorded parallelly with opioid requirement. 14 patients (5 males, 9 females) with average age 62±10,4 years were divided into three groups: n=6 (PENG), n=5 (FI), n=3 (Control). Mean NPS 1 hour after surgery was similar in PENG and FI block groups 3.3±1.23 vs. 4±1.26;p=0.37, but significantly lower compared to control group 7.3±0.47 with PENG (p=0.001) and FI (p=0.005). Although, mean NPS 8 hours after surgery was similar in PENG, FI and Control groups 2.2±0.68 vs. 2.2±0.4 vs. 3± 0.82; p=0.18, all patients in control group received Phentanyl for pain relief. Twenty-four hours after surgery statistically less pain was observed in PENG and FI block groups 1.8± 0.68 and 1.8±0.4 vs. control group 2.7±0.47; p=0.03. In FI and PENG groups, 2 patients, but in control group all patients received Phentanyl. The use of blocks allows to reduce the need for opioids in the postoperative period, but there is not a conclusive difference in pain intensity and opioid use between the FI and PENG blocks for postoperative analgesia.