Analgesic Efficacy of USG Guided Pericapsular Nerve Group Block Versus Intravenous Nalbuphine Hydrochloride In Patients of Intracapsular And Pericapsular Bony Hip Injuries: A Randomised Controlled Trial.

Hip fractures are a harrowing and dangerous orthopaedic emergency that commonly presents to the emergency department.

These painful hip fractures are often managed with opioid analgesics like IV morphine or nalbuphine.

But most of them are undermedicated in an overcrowded ED setup with limited resources to monitor as there are a lot of undesirable adverse effects like respiratory depression, bradycardia, hypotension and delirium, which gets aggravated especially if used in older patients.

An equally effective alternative to IV opioids can be PENG block which is a peripheral nerve block.

The PENG block was derived from the femoral nerve’s articular branches, obturator nerve, and accessory obturator nerve that provide sensory innervation to the anterior capsule of the hip joint. It was developed as a safe and potentially more effective alternative to femoral nerve block (FNB) and fascia iliaca block (FIB) for hip injuries.

As the injection targets the terminal branches of sensory nerves, it has only a motor-sparing effect facilitating early mobilization.

There have only been two case series about PENG block available in the literature, but no RCT has yet been done.

This RCT can set a milestone in managing inadequate analgesia in hip fractures in ED set up and better patient compliance.