The analgesic efficacy of pericapsular nerve group block in patients with intertrochanteric femur fracture: A randomized controlled trial

• Published in: PloS one Vol. 17; no. 10; p. e0275793
• Main Authors: Kong, Mingjian, Tang, Yan, Tong, Fei, Guo, Hui, Zhang, Xin Lei, Zhou, Lei, Ni, Hua, Wang, Bin, Liu, Yunqing, Liu, Jindong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.10.2022; Public Library of Science (PLoS)
• Subjects: Analgesia; Analgesics; Biology and Life Sciences; Care and treatment; Complications and side effects; Effectiveness; Fascia; Femoral Nerve; Femur; Fentanyl; Fractures; General anesthesia; Hemodynamics; Hip Fractures - surgery; Humans; Intravenous administration; Medical personnel; Medicine and Health Sciences; Muscle strength; Narcotics; Nerves; Pain; Pain perception; Pain, Postoperative - drug therapy; Patient outcomes; Patient safety; Patients; Quadriceps muscle; Remifentanil; Surgery; Ultrasonic imaging; Veins & arteries; China
• DOI: 10.1371/journal.pone.0275793
• ISSN: 1932-6203

The aim of this study is to evaluate analgesic efficacy of pericapsular nerve group (PENG) block in patients with intertrochanteric femur fracture (IFF). This double-blinded randomized controlled trial in patients with IFF scheduled for proximal femoral nail antirotation (PFNA) between December 2020 and November 2021. The primary outcome was VAS scores during exercising at 6 h after surgery; secondary outcomes were pain during exercising and rest, intraoperative dose of remifentanil, cumulative dose of postoperative fentanyl, postoperative analgesia satisfaction scores, and ratio of quadriceps weakness. A total of 50 patients were randomly divided into PENG block group (n = 25) or fascia iliaca compartment block (FICB) group (n = 25). Exercising VAS scores at 6 h after surgery were significantly lower in PENG block group than that in FICB group (2 (2, 4) vs. 6 (4, 7), P < 0.001). The intraoperative dose of remifentanil and cumulative dose of postoperative fentanyl by patient-controlled intravenous analgesia within 24 h after surgery in PENG block group were significantly lower than in FICB group (both P < 0.001). Postoperative analgesia satisfaction scores in PENG block group were significantly higher than those in FICB group (P = 0.016). The ratio of quadriceps weakness at 6 h after surgery was significantly higher in FICB group than PENG block group (48% vs. 0%, P < 0.001). Compared to FICB, ultrasound-guided PENG block may provide better postoperative pain relief in patients with IFF, with less pronounced quadriceps weakness.