Comparison of postoperative analgesic efficacy between PENG block and suprascapular nerve block in shoulder arthroscopy: a randomized controlled trial.

Abstract

Background: Patients commonly experience moderate to severe pain following shoulder arthroscopy. It is possible to reduce opioid consumption and hospital stay by using regional analgesia techniques in pain management. Currently, the suprascapular nerve block (SSNB) is widely used as an effective method to provide analgesia in shoulder surgeries. The pericapsular nerve group (PENG) block, on the other hand, is a newly described technique, and there is insufficient clinical research regarding its postoperative analgesic efficacy. This study aimed to compare the analgesic efficacy of SSNB and PENG blocks following shoulder arthroscopy.

Methods: In this prospective, randomized, controlled, single-center clinical trial, 74 patients undergoing shoulder arthroscopy were randomized into SSNB and PENG groups under ultrasound guidance. Postoperative pain was managed with tramadol HCl intravenous patient-controlled analgesia (PCA) and paracetamol as rescue analgesia. The primary outcome was postoperative pain scores. Secondary outcomes included cumulative opioid consumption during the first 36 hours postoperatively and patient satisfaction.

Results: No statistically significant differences were found between the SSNB and PENG groups in terms of postoperative pain scores (P=0.307). Cumulative opioid consumption and patient satisfaction were also similar between the two groups (P=0.307, P=0.397, respectively). However, the PENG block group had significantly shorter procedure times and lower pain scores during the block procedure compared to the SSNB group (P=0.045, P=0.032, respectively).

Conclusions: This study demonstrated that the PENG block, performed under ultrasound guidance, provided similar pain relief and opioid consumption reduction up to 36 hours postoperatively in various arthroscopic shoulder surgeries, including rotator cuff repair, Bankart repair, frozen shoulder, and impingement syndrome, compared to the SSNB. Given its shorter procedure time, less procedural pain, and similar clinical outcomes, the PENG block can be considered a good alternative to SSNB.