fatma ahmed mohamede abd elfatah
Asst. Professor
Comparison between pericapsular nerve group block and fascia iliaca compartment block for perioperative pain control in hip surgeries: A meta-analysis from randomized controlled trials
EGYPTIAN JOURNAL OF ANAESTHESIA • 2023
Publication Information
Authors
Samar Rafik Amin ; Fatma Ahmed
Keywords
Acute pain; nerve block; hip
joint fracture; analgesics;
postoperative pain; review
Journal
EGYPTIAN JOURNAL OF ANAESTHESIA
Publisher
Not Available
Volume
39
Issue
1
Pages
13
publication.type
Local
Paper Link
Open Link
Supplementary Materials
Not Available
Abstract
Background: To alleviate pain related to hip surgeries, pericapsular nerve group block (PENG)
is introduced as an innovative approach aims to improve analgesia without interfering with
muscle motor activity. In this study, we compared the effectiveness and safety of PENG block to
fascia iliaca compartment block (FICB) for managing acute pain related to hip operations.
Methods: Systematically looking through electronic databases, we only included randomized
controlled trials (RCTs) involving hip surgeries. The perioperative pain scores at various time
periods, postoperative narcotic demands in 24 h, the time of first opioid request, quality of
patient positioning during spinal anesthesia (SA), patients’ satisfaction, and adverse event
incidence between the two groups were obtained through the study.
Results: The analysis included nine RCTs with a total of 524 patients. Compared to the FICB,
PENG significantly reduced the pain scores early at 30 min post-block during positioning for SA
(SMD = −0.98, 95% CI: −1.76 to −0.20, P = 0.01), improved the quality of positioning, and
enhanced patient satisfaction. However, no significant differences were observed between
PENG and FICB regarding pain scores postoperatively at different time periods during rest and
exercise. Patients in the FICB group had more narcotic demands at 24 h post-surgical
(MD = −8.09, 95% CI: −14.25 to −1.93, P = 0.01). Otherwise, no differences were detected
regarding the time of first opioid request, postoperative complications, or length of
hospitalization.
Conclusions: PENG offered better benefits in terms of reducing pain, while the patient is being
positioned for SA and minimizing narcotic consumption over the first 24 hours following hip
surgeries.
is introduced as an innovative approach aims to improve analgesia without interfering with
muscle motor activity. In this study, we compared the effectiveness and safety of PENG block to
fascia iliaca compartment block (FICB) for managing acute pain related to hip operations.
Methods: Systematically looking through electronic databases, we only included randomized
controlled trials (RCTs) involving hip surgeries. The perioperative pain scores at various time
periods, postoperative narcotic demands in 24 h, the time of first opioid request, quality of
patient positioning during spinal anesthesia (SA), patients’ satisfaction, and adverse event
incidence between the two groups were obtained through the study.
Results: The analysis included nine RCTs with a total of 524 patients. Compared to the FICB,
PENG significantly reduced the pain scores early at 30 min post-block during positioning for SA
(SMD = −0.98, 95% CI: −1.76 to −0.20, P = 0.01), improved the quality of positioning, and
enhanced patient satisfaction. However, no significant differences were observed between
PENG and FICB regarding pain scores postoperatively at different time periods during rest and
exercise. Patients in the FICB group had more narcotic demands at 24 h post-surgical
(MD = −8.09, 95% CI: −14.25 to −1.93, P = 0.01). Otherwise, no differences were detected
regarding the time of first opioid request, postoperative complications, or length of
hospitalization.
Conclusions: PENG offered better benefits in terms of reducing pain, while the patient is being
positioned for SA and minimizing narcotic consumption over the first 24 hours following hip
surgeries.
