Comparison of supra-inguinal fascia iliaca versus pericapsular nerve block for ease of positioning during spinal anaesthesia

Abstract

Background and Aims: Regional analgesic techniques such as supra-inguinal fascia-iliaca compartment block (S-FICB) and pericapsular nerve group (PENG) block have been found to be effective in providing good pain relief in hip-fracture patients. However, comparative studies between PENG and S-FICB are lacking. The aim of this study was to compare the analgesic efficacy of S-FICB and PENG block and assess their efficacy in optimal patient positioning for spinal anaesthesia. Methods: A prospective randomised double-blind study was conducted in 66 patients randomly divided to receive either S-FICB or PENG block under ultrasound guidance. Primary outcome measures were numerical rating scale (NRS) pain score at rest and on passive 15° limb lifting, 30 minutes after the block and ease of spinal positioning. The secondary outcome measures were NRS over 24 hours, amount of tramadol used (number of rescue doses), patients' satisfaction and block-related complications. The results were analysed using statistical software (MedCalc version 19.2.1). Continuous and categorical data were analysed using appropriate statistical analysis and P < 0.05 was considered significant. Results: Post-block, the NRS score decreased significantly in PENG and S-FICB groups at rest and movement ( P < 0.0001). The EOSP score was significantly better in PENG group ( P < 0.0001). First analgesic request and pain relief in the first 24-hour period were similar between the groups ( P = 0.524). Conclusion: PENG block provided better pain relief and ease of positing during SA in patients with fractured hip scheduled for hip surgery.

Does pericapsular nerve group block have limited analgesia at the initial post-operative period? Systematic review and meta-analysis

“…Based on the Cochrane risk of the bias assessment tool, the quality of the included studies ranged from low to high quality with seven studies of low quality [15][16][17][18][19][20][21]; two of moderate quality [22,23]; and six high-quality studies [24][25][26][27][28][29]. Risk of bias graph and summary of quality assessment domains of included studies are shown in Figs.…”

Regional Anesthesia in the Emergency Department: an Overview of Common Nerve Block Techniques and Recent Literature

“…An RCT comparing FNB to FICB found equivalent levels of pain control with either block but more rapid relief with FNB [44]. There have been 3 randomized controlled trials comparing PENG to either FNB or FICB for operative analgesia in total hip arthroplasty, with two showing less short-term pain and better preservation of motor function with PENG [45,46]. However, all showed no significant difference in post-operative pain at 24 h [45][46][47].…”

Pericapsular nerve group block for hip fracture is feasible, safe and effective in the emergency department: A prospective observational comparative cohort study

“…10,[16][17][18][19] A perioperative study showed the PENG block to be superior to suprainguinal FICB prior to patient positioning for spinal anaesthesia. 16 The objective of the present study was to confirm the feasibility of the PENG block in everyday ED practice and to compare the safety and effectiveness of the PENG block to FB for patients with hip fracture in the ED. We hypothesised that it is safe and effective for emergency medicine clinicians to provide the PENG block for patients presenting to ED with a hip fracture.…”

“…15 Comparative literature for the PENG block is limited to the investigation of perioperative use of the technique by anaesthetists. 10,[16][17][18][19] A perioperative study showed the PENG block to be superior to suprainguinal FICB prior to patient positioning for spinal anaesthesia. 16 The objective of the present study was to confirm the feasibility of the PENG block in everyday ED practice and to compare the safety and effectiveness of the PENG block to FB for patients with hip fracture in the ED.…”

“…Existing literature supporting the PENG block for hip fractures is limited 15 . Comparative literature for the PENG block is limited to the investigation of perioperative use of the technique by anaesthetists 10,16–19 . A perioperative study showed the PENG block to be superior to suprainguinal FICB prior to patient positioning for spinal anaesthesia 16 …”