Analgesia and anesthesia using the pericapsular nerve group block in hip surgery and hip fracture: a scoping review

Author:

Morrison CraigORCID,Brown Brigid,Lin D-Yin,Jaarsma Ruurd,Kroon Hidde

Abstract

IntroductionPericapsular nerve group (PENG) block is a novel regional analgesia technique to reduce pain after hip surgery and hip fractures. This review was conducted to summarize current literature.MethodsA scoping review was carried out using the Joanna Briggs Institute framework. All articles describing the use of PENG block as a regional analgesia and/or anesthesia technique for hip pain were considered eligible for inclusion. Ovid Medline, Embase, CINAHL, PubMed and Google Scholar were searched. Adult and pediatric studies were included. Excluded were articles not available in English language, not available in full-text, related to non-orthopedic indications such as soft tissue surgery, and pelvic or femoral shaft fractures.ResultsDatabase searches identified 345 articles, 20 of which could be included in the current review, with a combined patient number of 74. Included articles comprised case reports and case series only, describing 1 to 10 patients. In all studies, PENG block was described to provide sufficient analgesia or anesthesia. Transient motor side effects occurred only when the local anesthetic was deposited in an unintended location (n=2).ConclusionsCurrent evidence of using PENG block for hip surgery or hip pain is limited to case reports and case series only. PENG block is a promising regional analgesia technique as an alternative to other regional nerve blocks such as femoral nerve block or iliac fascia nerve block. Observational and experimental studies are required to determine the effectiveness, efficacy and safety of the PENG block.

Publisher

BMJ

Subject

Anesthesiology and Pain Medicine,General Medicine

Reference27 articles.

1. Peripheral nerve blocks for hip fractures;Guay;Cochrane Database Syst Rev,2017

2. Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state

3. National Clinical Guideline Centre (NCGC) at the Royal College of Physicians . Chapter 7: Analgesia, paragraph 7.3. In: The management of hip fracture in adults. London, UK, 2019. https://www.nice.org.uk/guidance/cg124/evidence/full-guideline-pdf-183081997

4. Anatomic Study of Innervation of the Anterior Hip Capsule

5. Pericapsular Nerve Group (PENG) Block for Hip Fracture

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