The Pericapsular PENG Block as an Effective Strategy to Reduce Pain and Postoperative Analgesic Requirements in Hip Arthroscopy
DOI:
https://doi.org/10.63403/re.v32i2.389Keywords:
Hip Arthroscopy, FAI, Labrum, Analgesic BlockAbstract
Introduction: hip arthroscopy to treat femoroacetabular impingement syndrome (FAIS) has become increasingly common. A key challenge is managing immediate postoperative pain without excessive reliance on opioids. Currently, there is no standardized protocol that achieves effective analgesia without motor impairment. This study evaluates the pericapsular nerve group (PENG) block as a safe and effective alternative.
Objectives: to evaluate pain and analgesic use (morphine equivalents, ME) within the first twenty-four hours post-surgery using the pericapsular nerve group (PENG) block in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).
Materials and methods: a prospective, randomized study was conducted in patients with FAIS treated with hip arthroscopy by the same surgeon. Thirty-five patients received the PENG block and thirty-five did not. Pain was assessed using the visual analog scale (VAS) at eight hours, and morphine-equivalent consumption was recorded during the first twenty-four postoperative hours.
Results: of the eighty patients initially selected, ten were excluded (five for not meeting inclusion criteria and five who declined participation), resulting in seventy patients: thirty-five received the PENG block with 15 ml of 0.75% ropivacaine, and thirty-five did not. There were no differences in sex, age, laterality, or type of surgery. All patients received premedication with dexamethasone (8 mg), midazolam, and fentanyl, and spinal anesthesia with 0.5% isobaric bupivacaine. At the end of surgery, intravenous diclofenac and local infiltration with ropivacaine at the portals were administered. At eight hours, pain was lower in the PENG group (VAS 3.11 ± 0.99) compared to the non-block group (VAS 4.86 ± 1.21). Morphine-equivalent consumption over twenty-four hours was also lower (8.36 ± 6.15 ME vs. 18.64 ± 6.05 ME). All patients were discharged within twenty-four hours without complications.
Conclusion: the PENG block, combined with spinal anesthesia, effectively reduces pain and opioid use in the immediate postoperative period following hip arthroscopy for FAIS, supporting its inclusion in multimodal pain management.
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