Comparing the efficacy of ultrasound guided combined lateral femoral cutaneous nerve block and femoral nerve block with pericapsular nerve block for post operative analgesia in patients undergoing hip fracture surgeries using levobupivacaine:A prospective randomized study

Geriatric patients undergoing hip surgery often experience severe pain after the surgery especially in the early post operative period which can lead to respiratory and cardiac complications, prolonged hospital stays and impaired mobility which ultimately results in poor postoperative outcomes.

The pericapsular nerve group (PENG) block is a novel block for hip surgery and pain management in hip fractures that is slowly gaining popularity. This technique blocks all three nerves that innervate the anterior aspect of the hip with a single injection. This block yields excellent pain control with an extremely low incidence of motor block. This approach is unable to manage the pain from the surgical incision since it spares the lateral femoral cutaneous nerve (LFCN).

The combination of PENG plus LFCN block is a relatively new approach with only a small number of case series and case reports available in the literature. Facia iliaca compartment block (FICB) may cause motor weakness, hindering early mobilization. PENG block, a novel technique, targets articular branches of key nerves, offering effective pain relief without significant motor impairment. The addition of lateral cutaneous nerve of thigh block to PENG block may further enhance analgesia.