The Analgesic effect of adding ultrasound-guided pericapsular nerve group block to suprainguinal fascia iliaca compartment block for hip fracture surgery: A prospective randomized controlled trial
Issued Date
2023-11-03
Resource Type
eISSN
15365964
Scopus ID
2-s2.0-85176360515
Pubmed ID
37932971
Journal Title
Medicine
Volume
102
Issue
44
Rights Holder(s)
SCOPUS
Bibliographic Citation
Medicine Vol.102 No.44 (2023) , e35649
Suggested Citation
Nuthep L., Klanarong S., Tangwiwat S. The Analgesic effect of adding ultrasound-guided pericapsular nerve group block to suprainguinal fascia iliaca compartment block for hip fracture surgery: A prospective randomized controlled trial. Medicine Vol.102 No.44 (2023) , e35649. doi:10.1097/MD.0000000000035649 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/91111
Title
The Analgesic effect of adding ultrasound-guided pericapsular nerve group block to suprainguinal fascia iliaca compartment block for hip fracture surgery: A prospective randomized controlled trial
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
BACKGROUND: Both suprainguinal ultrasound-guided fascia iliaca compartment block (FICB) and pericapsular nerve group (PENG) block have been used to treat pain after hip surgery. Motor-sparing PENG block may further expedite early postoperative rehabilitation. This study aimed to compare the analgesic efficacy and recovery outcome of suprainguinal ultrasound-guided FICB alone with FICB combined with PENG block for hip fracture surgery. METHODS: In this study, 59 elderly patients undergoing hip fracture surgery were randomized to receive either FICB alone or combined FICB + PENG block. The primary outcome was pain score at rest 12 hours after surgery as measured by the numerical rating scale (NRS, 0-10) and secondary outcomes were pain scores at rest and with movement measured at other time points within 48 hours, time to first sit up without pain, rescue morphine requirements, opioid-related side effects, incidence of delirium, in-hospital morbidities and mortality, and length of hospital stay. RESULTS: Both patient groups had similar demographic profile and postoperative pain scores at rest and with movement. Median NRS pain scores at rest between FICB alone or combined FICB + PENG block at 4, 8, 12, 24, 36 and 48 hours after surgery were 3 versus 3 (P = .31), 3 versus 3 (P = .21) and 3 versus 3 (P = .69), 2 versus 2 (P = .35), 2 versus 3 (P = .17), 3 versus 2 (P = .18) respectively and NRS during movement at 12, 24, 48 hours were 10 versus 8 (P = .30), 6 versus 5 (P = .54) and 3.5 versus 2.0 (P = .64), respectively. There was also no significant difference in the time for patients to first sit up without pain (17.50 vs 19.37 hours vs h; P = .058) or any other secondary outcome measures. The procedure time was, however, significantly longer for the FICB + PENG block (10 vs 5 minutes, P < .001). CONCLUSION: Addition of ultrasound-guided PENG block to FICB did not improve postoperative analgesic or recovery outcomes in elderly patients undergoing hip fracture surgery.