A randomised controlled trial to assess the efficacy of Pericapsuler Nerve Group Block verses Lumbar Plexus Block for postoperative analgesia in patients undergoing hip surgery

Hip fracture is a common orthopedic emergency, & associated with significant morbidity and mortality. Surgical reduction and fixation is the definitive treatment in most patients to improve mobility and quality of life. Adequate pain relief is essential in the postoperative period to enable ambulation and initiation of physiotherapy.

Various methods have been used to provide post op analgesia. Intravenous patient-controlled analgesia (IV PCA) or epidural analgesia are the most common methods. IV PCA is associated with poor pain control and opioid associated complications. Epidural analgesia may lead to hemodynamic instability and bilateral motor block.

Recently, peripheral nerve blockade has emerged alternative analgesic approach.4 Femoral nerve block and fascia illiaca block are useful however they are associated with inadequate pain control for hip surgery because of low propensity to block obturator nerve.

Lumbar plexus block or psoas compartment blocks has been considered Gold standard, as it reliably block all its branches including obturator nerve and provide potent analgesia with reduce opioid consumption for hip surgery. It is a deep block and technically challenging even with the use of ultrasound.

Recently ultrasound guided Pericapsular Nerve Group (PENG) block has been described which block articular branches of hip supplied by femoral, obturator, and accessory obturator nerve. Technique for PENG block is easy as it is quite superficial as well as initial data on its application and hip surgery is in encouraging.