Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial.

Abstract

Peripheral nerve block can provide effective postoperative analgesia to patients undergoing total hip arthroplasty (THA). This study aimed to compare ultrasound-guided pericapsular nerve group (PENG) block against anterior quadratus lumborum (AQL) block for pain management in primary THA. In this prospective, double-blind, randomized controlled trial, 90 patients undergoing primary THA under general anesthesia were randomly allocated to receive ultrasound-guided PENG block + sham AQL block ("PENG group") or ultrasound-guided AQL block + sham PENG block ("AQL" group). The primary outcome was the highest pain score on a visual analogue scale while the patient was in the recovery room. Secondary outcomes included pain scores after transfer out of the recovery room, morphine consumption, quadricep strength, duration of hospitalization, pain level one year after surgery, and incidence of complications. Patients in the PENG group reported significantly lower maximum pain scores in the recovery room (31.3±9.1 vs. 37.3±7.4, p=0.001), as well as significantly lower pain scores at rest at 3 h after surgery and during motion at 3 and 6 h after surgery. The two groups did not differ significantly in postoperative morphine consumption, length of hospitalization, pain level at one year after surgery, or incidence of complications. Neither block significantly weakened the quadriceps. PENG block may provide slightly more effective postoperative analgesia than AQL block during the early recovery period after primary THA.