Comparative Study to Evaluate the Effect of Ultrasound-Guided Pericapsular Nerve Group Block Versus Fascia Iliaca Compartment Block on the Postoperative Analgesic Effect in Patients Undergoing Surgeries for Hip Fracture under Spinal Anesthesia.

Abstract

Background:Fractures in and around the hip are a major concern in young as well as the elderly. Ultrasound-guided (USG) peripheral nerve blocks help in early surgical fixation of these fractures by providing perioperative pain relief as well as early mobilization resulting in reduced morbidity and mortality.Aims:This study aims to compare the efficacy of USG pericapsular nerve group (PENG) block versus fascia iliaca compartment (FIC) block.Setting and Design:Prospective, randomized, double-blind, controlled study.Materials and Methods:Twenty-four patients above 18 years of age with hip fracture belonging to the American Society of Anaesthesiologists physical status Classes I and II scheduled for hip surgery were randomly allocated into two groups. Group 1(PENG block) received USG-guided PENG block and Group 2 (FIC block) received USG guided FIC block for postoperative pain relief. Postoperative pain relief (at rest) was evaluated by Numeric Rating Scale score from 20th min and at regular interval for 24 h. The total analgesic consumption in the first 24 h was also noted.Statistical Analysis Used:Data were analyzed by using nonparametric test and Chi-square test. Hemodynamic variables and pain scores were analyzed using analysis of variance for two groups and independent t-test was used for comparison between two groups.Results:Postoperative NRS score was higher in FIC block than PENG block which was statistically significant at 1 h (P = 0.035) and at 4 h (P = 0.001). The first requirement of analgesic was significantly late in PENG block group (8.17 ± 3.129) as compared to FIC block group (4.00 ± 1.477).Conclusions:PENG block provides better postoperative analgesia, with reduced requirement of rescue analgesics in 24 h as compared to FIC block in patients undergoing surgeries for hip fracture under spinal anesthesia.