Preoperative Analgesic efects of PENG block in hip fracture

Abstract

Hip fractures are a very common and a highly prevalent pathology in our setting, being one of the main reasons for visit in the emergency room. Regional analgesia in patients with hip fracture is a procedure frequently performed in the perioperative period since it allows the patient to offer adequate analgesia as well as a decrease in the consumption of intravenous opioids and their derived secondary effects. In recent years, epidural analgesia, femoral nerve block and fascia iliac blocks have been the post used techniques in hip fracture analgesia, achieving motor and sensory block in most patients, sometimes making initial ambulation later due to a weak of the psoas muscle. Recently, several anatomical studies have highlighted the importance of the sensory innervation of the articular hip inervation, developing the PENG approach and describing it as a more complete technique with better analgesic results than the approaches used before. In this block, an absence of motor weakness has been reported. We present four clinical cases of patients with hip fracture who underwent PENG block; the approach and the technique used are exposed, as well as the results obtained in terms of analgesia, valued using the visual analógic scale (EVA). This approach offers promising results, so it can be very useful in providing quality analgesia in patients with hip fractures in the preoperative period. Further studies may be interesting to validate the efficacy and superiority of the PENG blocks over the conventional techniques described.