Pericapsular nerve group block for analgesia of positioning pain during spinal anesthesia in hip fracture patients, a randomized controlled study

Abstract

Background: Spinal anesthesia has been favored by many anesthesiologists due to the simplicity of the technique, the lower incidence of complications like delirium and thromboembolic events. However, severe pain, encountered during positioning for spinal anesthesia, can complicate the technique and worsen the patient experience. Different regional blocks were employed to facilitate patient positioning for spinal anesthesia. Pericapsular nerve group (PENG) block is a recently regional technique based on blocking the articular branches to the hip joint. In our study, the PENG block was used for analgesia during positioning of patient with hip fractures for spinal anesthesia. Methods: In this study, patients randomly divided into two groups, using closed envelope technique in blocks of 10; Control group (n = 30), and PENG group (n = 30). In the PENG group, the block was performed 30 minutes before spinal anesthesia, with the patient in the supine position using ultrasound guidance. Patient experience during positioning for spinal anesthesia was assessed and compared to the control group. Results: The PENG block was associated with statistically significant lower pain levels (p 0.00), better patient sitting angle (p 0.00) during positioning for spinal anesthesia compared to the control group. Conclusion: Preoperative PENG block is an effective option to control positioning related pain during spinal anesthesia, improved patient sitting angle, thus decreased the time required for spinal block and improved the anesthesiologist and patient experience.