Single-pass needle trajectory for lateral femoral cutaneous nerve and PENG blocks, and caution to avoid injury

Nanda, Monika; Rojas, Andrés; Stander, Sally; Armbruster, Jeremy; Anumudu, Chinwe; Jolly, Maxwell; Schoenherr, Jay; Maquoit, Gisselle; Grant, Stuart A.

doi:10.1136/rapm-2022-103782

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…However, we chose this method to avoid unnecessary harm to the patient. Although largely safe, the PENG block may carry the risk of serious complications such as accidental harm to the lateral femoral cutaneous nerve 18…”

Section: Discussionmentioning

confidence: 99%

Pericapsular nerve group (PENG) block for early pain management of elderly patients with hip fracture: a single-center double-blind randomized controlled trial

Lin

Liu

Goh

et al. 2023

Reg Anesth Pain Med

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BackgroundThe pericapsular nerve group block (PENG) is a novel technique that blocks the articular branches of the hip joint. This study aimed to compare its effectiveness to a sham block in elderly patients with hip fractures.MethodA randomized double-blind controlled trial was conducted in elderly patients with intertrochanteric and neck of femur fractures. Patients were randomized to receive either PENG block or a sham block. Postblock, systemic analgesia was titrated using a standardized protocol of acetaminophen, oral morphine or patient-controlled analgesia. The primary outcome was the dynamic pain score (Numerical Rating Scale 0–10) at 30 min postblock. Secondary outcomes included pain scores at multiple other time points and 24-hour opioid consumption.Results60 patients were randomized and 57 completed the trial (PENG n=28, control n=29). Patients in PENG group had significantly lower dynamic pain scores at 30 min compared with control group (median (IQR) 3 (0.5–5) vs 5 (3–10), p<0.01). For the secondary outcomes, dynamic pain scores were lower in PENG group at 1 hour (median (IQR) 2 (1–3.25) vs 5 (3–8), p<0.01) and 3 hours postblock (median (IQR) 2 (0–5) vs 5 (2–8), p<0.05). Patients in PENG group had lower 24-hour opioid consumption (median (IQR) oral morphine equivalent dose 10 (0–15) vs 15 (10–30) mg, p<0.05).ConclusionPENG block provided effective analgesia for acute traumatic pain following hip fracture. Further studies are required to validate the superiority of PENG blocks over other regional techniques.Trial registration numberNCT04996979.

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Section: Discussionmentioning

confidence: 99%

Pericapsular nerve group (PENG) block for early pain management of elderly patients with hip fracture: a single-center double-blind randomized controlled trial

Lin

Liu

Goh

et al. 2023

Reg Anesth Pain Med

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Comparison of analgesic effect of pericapsular nerve group block and supra-inguinal fascia iliaca compartment block on dynamic pain in patients with hip fractures: a randomized controlled trial

Koh,

Kim,

Kim

et al. 2024

Reg Anesth Pain Med

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BackgroundPatients with hip fracture often experience severe pain, particularly during movement or slight positional change, prior to the occurrence of surgery. It is essential to explore the appropriate analgesic methods before surgery in patients with hip fracture, especially those capable of alleviating dynamic pain. Pericapsular nerve group (PENG) block was introduced as a useful technique for hip analgesia. In this study, we aimed to compare the reduction in dynamic pain between the PENG block and supra-inguinal fascia iliaca compartment block (SIFICB).MethodsThis prospective trial included 80 hip fracture patients aged ≥19 years, with an American Society of Anesthesiologists Physical Status of 1–4 and a baseline dynamic pain score ≥4 on the numerical rating scale. The patients were randomly allocated into the PENG block (n=40) and SIFICB group (n=40). For the PENG block and SIFICB, 20 mL and 30 mL of 0.3% ropivacaine was used, respectively. The primary outcome was reduction in dynamic pain scores at 30 min following the peripheral nerve block. Dynamic pain score was evaluated when the leg was passively raised.ResultsA total of 79 patients were included in the final analysis, and the reductions in pain score during hip flexion were 3.1±2.4 and 2.9±2.5 in the PENG block and SIFICB groups, respectively, which was statistically insignificant (p=0.75). Moreover, no significant differences were observed in any of the outcomes.ConclusionsPENG block and SIFICB could effectively provide analgesia for dynamic pain in patients with hip fractures, with no significant difference between the two groups.Trial registration numberNCT04677348.

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Single-pass needle trajectory for lateral femoral cutaneous nerve and PENG blocks, and caution to avoid injury

Cited by 2 publications

References 7 publications

Pericapsular nerve group (PENG) block for early pain management of elderly patients with hip fracture: a single-center double-blind randomized controlled trial

Pericapsular nerve group (PENG) block for early pain management of elderly patients with hip fracture: a single-center double-blind randomized controlled trial

Comparison of analgesic effect of pericapsular nerve group block and supra-inguinal fascia iliaca compartment block on dynamic pain in patients with hip fractures: a randomized controlled trial

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