Pradeep Trishna, Nayak Mahesh, Misquith Julie C R, Naik Shilpa A, Osmani Shaik Gulam
Department of Anaesthesiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Ann Afr Med. 2025 Jun 30. doi: 10.4103/aam.aam_46_25.
Pericapsular nerve group (PENG) block is a novel approach for dynamic pain relief in hip fractures. Studies on the effectiveness of PENG block for positioning for spinal anesthesia are very few in the Indian population. This study aimed to identify the superior efficacy of PENG block over femoral block for positioning during spinal anesthesia for hip surgeries. This study will help use the PENG block as a better approach to currently used blocks without sparing any articular branches of the nerves to the hip joint.
Seventy-four patients who were scheduled for hip surgeries for femur fracture were assigned into femoral and PENG groups who received the block before spinal anesthesia. Both groups received 20 mL of 0.25% bupivacaine injected around the femoral nerve. The primary outcome was measured using hemodynamic parameters, visual analog scale (VAS) score, and duration of postoperative analgesia. Secondary outcomes were measured with postoperative analgesic use.
Static and dynamic VAS were significantly different between both groups. Patients from the femoral group showed a significant reduction in static (P = 0.001) and dynamic VAS (P = 0.006) when compared to the PENG group. Static pain and dynamic pain on passive motion after the block had significantly reduced in patients who received femoral block as compared to those who received PENG block. A highly significant difference was seen at 5, 10, and 15 min after the block. While positioning, patients from both groups sat comfortably for spinal anesthesia.
PENG block is a novel alternative technique for regional anesthesia for the hip. We conclude that both PENG and femoral block provide adequate analgesia for positioning for spinal anesthesia.
关节囊周围神经组（PENG）阻滞是一种缓解髋部骨折动态疼痛的新方法。在印度人群中，关于PENG阻滞用于脊髓麻醉定位有效性的研究非常少。本研究旨在确定在髋部手术脊髓麻醉期间，PENG阻滞相对于股神经阻滞在定位方面的更高疗效。本研究将有助于将PENG阻滞作为一种比目前使用的阻滞更好的方法，同时不损伤任何支配髋关节的神经关节支。
74例计划行股骨骨折髋部手术的患者被分为股神经组和PENG组，在脊髓麻醉前接受阻滞。两组均在股神经周围注射20 mL 0.25%布比卡因。主要结局通过血流动力学参数、视觉模拟量表（VAS）评分和术后镇痛持续时间来衡量。次要结局通过术后镇痛药物使用情况来衡量。
两组的静态和动态VAS有显著差异。与PENG组相比，股神经组患者的静态VAS（P = 0.001）和动态VAS（P = 0.006）显著降低。与接受PENG阻滞的患者相比，接受股神经阻滞的患者在阻滞后被动运动时的静态疼痛和动态疼痛明显减轻。在阻滞后5、10和15分钟时观察到高度显著差异。在定位时，两组患者都能舒适地坐着接受脊髓麻醉。
PENG阻滞是一种用于髋部区域麻醉的新型替代技术。我们得出结论，PENG阻滞和股神经阻滞都为脊髓麻醉定位提供了充分的镇痛效果。
