Articles
5 August 2025
Vol. 3 No. 1 (2025)
Hip arthroplasty under pericapsular nerve group blocks combined with local anesthesia
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Hip arthroplasty and endoprosthesis surgery typically utilize general or spinal anesthesia, but regional techniques like the PENG block offer potential analgesic benefits. This report presents three cases in which a modified ultrasound-guided pericapsular infiltration technique is used as the only technique for hip surgery. Three patients undergoing hip arthroplasty/endoprosthesis surgery with different approaches (direct anterior, lateral, and posterolateral) received ultrasound-guided anterior and posterior pericapsular injections (A-PENG and PONG) and additional local anesthetic infiltration tailored to the surgical approach. All patients experienced successful intraoperative anesthesia and adequate postoperative analgesia within 24 hours, with no motor block. The technique was adaptable to different approaches and patient characteristics. This case series suggests the feasibility and potential benefits of the pericapsular nerve blocks as a regional anesthesia option for hip surgery. Further research is needed to compare its efficacy, safety, and cost-effectiveness with other techniques in larger, controlled studies.
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1. Florschutz AV, Langford JR, Haidukewych GJ, Koval KJ. Femoral neck fractures: current management. J Orthop Trauma 2015;29:121-9. DOI: https://doi.org/10.1097/BOT.0000000000000291
2. LeBlanc KE, Muncie HL Jr., LeBlanc LL. Hip fracture: diagnosis, treatment, and secondary prevention. Am Fam Physician 2014;89:945-51.
3. Klestil T, Röder C, Stotter C, et al. Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis. Sci Rep 2018;8:13933. DOI: https://doi.org/10.1038/s41598-018-32098-7
4. Memtsoudis SG, Cozowicz C, Bekeris J, et al. Anaesthetic care of patients undergoing primary hip and knee arthroplasty: consensus recommendations from the International Consensus on Anaesthesia-Related Outcomes after Surgery group (ICAROS) based on a systematic review and meta-analysis. Br J Anaesth 2019;123:269-87. DOI: https://doi.org/10.1016/j.bja.2019.05.042
5. Messina A, La Via L, Milani A, et al. Spinal anesthesia and hypotensive events in hip fracture surgical repair in elderly patients: a meta-analysis. J Anesth Analg Crit Care 2022;2:19. DOI: https://doi.org/10.1186/s44158-022-00047-6
6. Del Buono R, Padua E, Pascarella G, et al. Pericapsular nerve group block: an overview. Minerva Anestesiol 2021;87:458-66. DOI: https://doi.org/10.23736/S0375-9393.20.14798-9
7. Del Buono R, Padua E, Pascarella G, et al. Continuous PENG block for hip fracture: a case series. Reg Anesth Pain Med 2020;45:835-8. DOI: https://doi.org/10.1136/rapm-2020-101446
8. Girón-Arango L, Peng PWH, Chin KJ, et al. Pericapsular Nerve Group (PENG) Block for Hip Fracture. Reg Anesth Pain Med 2018;43:859-63. DOI: https://doi.org/10.1097/AAP.0000000000000847
9. Morrison C, Brown B, Lin DY, et al. Analgesia and anesthesia using the pericapsular nerve group block in hip surgery and hip fracture: a scoping review. Reg Anesth Pain Med 2021;46:169-75. DOI: https://doi.org/10.1136/rapm-2020-101826
10. Pascarella G, Costa F, Del Buono R, et al. Defining the optimal spread of local anesthetic during pericapsular nerve group (PENG) block may help to avoid short-term motor block (reply to Aliste et al). Reg Anesth Pain Med 2022;47:200-1. DOI: https://doi.org/10.1136/rapm-2021-103086
11. Del Buono R, Pascarella G, Costa F, Barbara E. Ultrasound-guided local infiltration analgesia for hip surgery: myth or reality? Minerva Anestesiol 2019;85:1242-3. DOI: https://doi.org/10.23736/S0375-9393.19.13701-7
12. Del Buono R, Pascarella G, Padua E, et al. PENG block: from standard to unconventional approaches. Minerva Anestesiol 2021;87:1157-8. DOI: https://doi.org/10.23736/S0375-9393.21.15847-X
13. Andrade PP, Lombardi RA, Marques IR, et al. Pericapsular Nerve Group (PENG) block versus fascia iliaca compartment (FI) block for hip surgery: a systematic review and meta-analysis of randomized controlled trials. Braz J Anesthesiol 2023;73:794-809. DOI: https://doi.org/10.1016/j.bjane.2023.07.007
14. Farag A, Hendi NI, Diab RA. Does pericapsular nerve group block have limited analgesia at the initial post-operative period? Systematic review and meta-analysis. J Anesth 2023;37:138-53. DOI: https://doi.org/10.1007/s00540-022-03129-5
15. Pascarella G, Costa F, Del Buono R, et al. Impact of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial. Anaesthesia 2021;76:1492-8. DOI: https://doi.org/10.1111/anae.15536
16. Tran J, Agur A, Peng P. Is pericapsular nerve group (PENG) block a true pericapsular block? Regional Anesthesia & Pain Medicine 2019;44:257. DOI: https://doi.org/10.1136/rapm-2018-100278
17. Nielsen ND, Greher M, Moriggl B, et al. Spread of injectate around hip articular sensory branches of the femoral nerve in cadavers. Acta Anaesthesiol Scand 2018;62:1001-6. DOI: https://doi.org/10.1111/aas.13122
18. Vermeylen K, Van Aken D, Versyck B, et al. Deep posterior gluteal compartment block for regional anaesthesia of the posterior hip: a proof-of-concept pilot study. BJA Open 2023;5:100127. DOI: https://doi.org/10.1016/j.bjao.2023.100127
How to Cite
Hip arthroplasty under pericapsular nerve group blocks combined with local anesthesia. (2025). Advances in Anesthesia and Pain Medicine, 3(1). https://doi.org/10.4081/aapm.45.
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