Beyond the Pericapsular Nerve Group (PENG) Block: A Narrative Review

Teles, Ana Sofia; Altınpulluk, Ece Yamak; Sahoo, Rajendra Kumar; Galluccio, Felice; Simón, Diego García; İnce, İlker; Olea, Marilina Susana; González‐Arnay, Emilio; Salazar, Carlos; Espinoza, Karla; Fajardo‐Pérez, Mario

doi:10.5152/tjar.2021.21230

Cited by 5 publications

(6 citation statements)

References 48 publications

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“…Short et al also identified pertinent anatomical landmarks for finding the articular branches of the hip joint: the "teardrop" bone thickening of the inferomedial acetabulum for ON, the anterior superior iliac spine (AIIS), and the iliopubic eminence (IPE) for FN and AON [31]. These findings inspired Giron et al to develop the PENG block in order to more effectively target the FN and AON between the AIIS and IPE [28,32].…”

Section: Anatomy and Techniquementioning

confidence: 99%

“…After needle positioning and negative aspiration, a volume of 8-30 mL of local anesthetics (e.g. bupivacaine, ropivacaine, or lidocaine) may be injected for analgesia [28,32]. With the out-of-plane technique, the ultrasound probe is placed at the level of the anterior superior iliac spine (ASIS) parallel to the inguinal fold then rotated median until the upper pubic ramus is visible.…”

Section: Anatomy and Techniquementioning

confidence: 99%

See 1 more Smart Citation

Novel Techniques and Local Anesthetics for Perioperative Pain Management

Wang,

Kerolus,

Garry

et al. 2023

Advances in Regional Anesthesia - Future Directions in the Use of Regional Anesthesia

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Careful perioperative pain management is crucial for good patient outcomes after surgery, as poorly controlled pain interferes with the ability of patients to recover to normal baseline function and increases postoperative morbidity and mortality. Although opioids have been the mainstay for treating postoperative pain, there has been a shift in favor of a multimodal analgesic approach, including regional anesthesia, as a way to circumvent opioid-related adverse events (e.g. nausea and vomiting, respiratory depression, sedation). In this chapter, we present an update on several recently developed regional anesthetic techniques, local anesthetic medications, as well as nerve block adjuncts with the potential to improve pain management in the perioperative setting. With more future studies, these novel methods may be incorporated into postsurgical recovery protocols and provide the opportunity to improve patient outcomes.

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Section: Anatomy and Techniquementioning

confidence: 99%

Section: Anatomy and Techniquementioning

confidence: 99%

Novel Techniques and Local Anesthetics for Perioperative Pain Management

Wang,

Kerolus,

Garry

et al. 2023

Advances in Regional Anesthesia - Future Directions in the Use of Regional Anesthesia

View full text Add to dashboard Cite

show abstract

“…There was a significant reduction in opioid consumption, a better range of hip motion and a shorter time to ambulation [37]. It is a motor sparing block, easy to perform and has a low rate of complications [38]. The main disadvantage is that it cannot be used as a sole peripheral nerve block for hip surgery and needs an additional modality to cover pain at the incision site.…”

Section: Pericapsular Nerve Group Block (Peng Block)mentioning

confidence: 99%

Current Concepts in Postoperative Pain Management Surgeries of Hip Joint: A Narrative Review

Gupta¹,

Kaushal²,

Malviya³

et al. 2022

IJRA

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Hip surgery is a common surgical procedure in the elderly and leads to significant pain postoperatively. The hip joint has a complex innervation which is unlikely to be covered with any single modality of pain relief. Multimodal analgesia has been critical in facilitating early recovery and rehabilitation in these patients. Regional analgesia is an important component of multimodal analgesia regimens and is instrumental in achieving optimal patient outcomes. Single shot or continuous central or peripheral nerve blocks provide effective and safe postoperative analgesia, lower opioid consumption, faster rehabilitation, and a high level of patient satisfaction. An ideal regional anaesthesia technique for hip surgery should be motor sparing while providing effective perioperative pain relief. Regional anaesthesia has seen enormous growth in the recent past due to advances in technology and research. These blocks have shown analgesic efficacy, have an opioid-sparing effect, and enable better patient positioning for central neuraxial blocks. Some of the novel interfascial plane blocks like Pericapsular Nerve Group (PENG) block are now being explored for hip analgesia. Within a few years of being described, these novel nerve blocks have seen tremendous favour in the literature and are being extensively used in the current practice of analgesia for hip surgery. In the present review, we aim to discuss the various modalities of analgesia which have been utilised in the past and would discuss few of the newer blocks for hip surgery. Keywords: Nerve blocks, Ultrasonography, Analgesics, Total hip arthroplasty, Fascia illiaca block, Multimodal analgesia, Transmuscular, Quadratus lumborum block

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“…The hip's anterior capsule, which has the most extensive innervation, is the target of this block technique. [13][14][15] The efficiency of the PENG block was examined in the study for the most prevalent hip pain aetiologies. This study investigated the effectiveness and safety of PENG block, which provides successful and targeted postoperative pain control in a short amount of time for chronic hip pain for which adequate analgesic treatment is still not known.…”

Section: Introductionmentioning

confidence: 99%

“…The hip’s anterior capsule, which has the most extensive innervation, is the target of this block technique. 13–15…”

Section: Introductionmentioning

confidence: 99%

PENG for chronic pain: the clinical effectiveness of pericapsular nerve group block in chronic hip pain

Karaoğlan,

Küçükçay Karaoğlan

2024

HIP International

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Objectives: To evaluate the efficiency and tolerability of pericapsular nerve group block (PENG) for the treatment of chronic hip pain. Methods: This is a retrospective, single-centre, 4-group study conducted over a 3-month period to find out the most typical cause of chronic hip pain. A total of 112 patients with symptomatic hip osteoarthritis (OA), Stage 2–3, greater trochanteric pain (GTPS) and chronic pain after total hip arthroplasty (cTHA), who had an ultrasound-guided PENG block, were selected. To assess the effectiveness of the treatment, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analogue scale (VAS) scores of the patients prior to treatment were compared with their scores after the 1st week, 1st month, and 3rd month of treatment. The study also aimed to analyse the patients’ initial feelings of alleviation following the block (1st VAS/2) and problems experienced both during and after the block. Results: The parameters studied included pain, stiffness, and results of physical activity in the 1st week, 1st month, and 3rd month following PENG block application. At the beginning of the 1st week, of the 112 patients who were administered a PENG block for hip pain, we reported a 62% improvement in pain, a 52% reduction in stiffness, and a 53% increase in physical activity. Even though these results slightly declined in the 1st and 3rd months, the rates were still higher than 45%. Conclusions: Overall, the PENG block was well-tolerated by the patients in our study. No treatment-related infections or any other serious complications were observed.

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Beyond the Pericapsular Nerve Group (PENG) Block: A Narrative Review

Cited by 5 publications

References 48 publications

Novel Techniques and Local Anesthetics for Perioperative Pain Management

Novel Techniques and Local Anesthetics for Perioperative Pain Management

Current Concepts in Postoperative Pain Management Surgeries of Hip Joint: A Narrative Review

PENG for chronic pain: the clinical effectiveness of pericapsular nerve group block in chronic hip pain

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