Comparison of the postoperative analgesic efficacy of pericapsular nerve group block (PENG) and anterior quadratus lumborum block in hip fracture surgery: A prospective randomized study.

Abstract

ObjectiveIn recent years, the pericapsular nerve group (PENG) block and anterior quadratus lumborum block (aQLB) have emerged as regional anesthesia techniques commonly used for pain control after hip surgery. This study compared their analgesic efficacy during the first 48 hours following surgery under spinal anesthesia.MethodsIn this prospective, randomized, single-blinded study, patients were assigned to either the PENG (n = 43) or the aQLB group (n = 30). The primary outcome of the study was the total tramadol consumption within the first 48 hours postoperatively. Secondary outcomes included time to first rescue analgesia, resting and dynamic NRS pain scores at 2, 12, 24, and 48 hours postoperatively, and the incidence of complications.ResultsIn this study, postoperative tramadol consumption within the first 48 hours was significantly lower in the PENG (96.74 ± 77.36 mg) compared to the aQLB group (196.33 ± 157.43 mg) (p = 0.004). Additionally, the time to first rescue analgesia was significantly longer in the PENG (9.03 ± 7.67 hours) than in the aQLB group (6.81 ± 6.70 hours) (p = 0.048). NRS scores were similar between the groups at all time points. Quadriceps weakness was not observed in any patient.ConclusionThe PENG block provides effective postoperative analgesia without causing motor blockade, making it advantageous for early mobilization in patients undergoing hip surgery. It can be used as a part of multimodal analgesia.