Case Reports
16 June 2025
Vol. 3 No. 1 (2025)
Hip arthroplasty under pericapsular nerve group blocks combined with local anesthesia: a report on three different surgical techniques
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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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Citations
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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.
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.
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.
12. Del Buono R, Pascarella G, Padua E, et al. PENG block: from standard to unconventional approaches. Minerva Anestesiol 2021;87:1157-8.
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.
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How to Cite
Hip arthroplasty under pericapsular nerve group blocks combined with local anesthesia: a report on three different surgical techniques. (2025). Advances in Anesthesia and Pain Medicine, 3(1). https://doi.org/10.4081/aapm.2025.45
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