Comparison of the perioperative efficacy of pericapsular nerve group (PENG) block and the suprainguinal fascia iliaca compartment block (S-FICB) in patients undergoing hip fracture surgery: Spinal positioning, medication usage, and patient satisfaction.

Abstract

Background: This study aimed to compare the effects of pericapsular nerve group (PENG) block and suprainguinal fascia iliaca compartment block (S-FICB) on perioperative pain control in patients undergoing surgery for intertrochanteric femoral fractures.

Methods: Patients who underwent surgery for intertrochanteric femoral fractures between June 2021 and June 2024 were retrospectively analyzed. The study included patients who underwent surgery for intertrochanteric femoral fractures using a proximal femoral nail under spinal anesthesia, combined with either a PENG block or an S-FICB. The patients were divided into two groups: those who underwent a PENG block were assigned to Group I, and those who received an S-FICB were assigned to Group II. Functional assessments included perioperative numerical rating scale (NRS) scores, the timing and amount of systemic analgesics use, patient satisfaction, nausea, vomiting, and motor muscle strength.

Results: The spinal positioning score was significantly better in Group I (p<0.01). NRS scores were significantly lower in Group I at the 6th and 12th hours during exercise (p<0.001). Patient satisfaction scores were also significantly higher in Group I (p=0.04). The time to first opioid use was earlier, and the total opioid dose was higher, in Group II (p=0.03 and p=0.04, respectively).

Conclusion: The PENG block, with its more potent analgesic effect, easier positioning, lower opioid consumption, and higher patient satisfaction, emerges as a promising option for hip fracture surgery.