The Efficiency of Ultrasound-Guided Pericapsular Nerve Group Block for Pain Management after Hip Surgery: A Meta-analysis.

Abstract

Patients with hip surgery often experience moderate to severe postoperative pain, and need large doses of opioids to relieve it, which is not conducive to patient rehabilitation. Pericapsular nerve group (PENG) block is a new regional block technique that is considered to reduce postoperative pain and the use of opioids. The purpose of this study was to evaluate the efficacy and safety of PENG block for postoperative analgesia after hip surgery. We searched multiple databases for randomized controlled trials (RCTs) published in English, which compared PENG block with fascia iliaca compartment block (FICB). The primary outcome was 24h postsurgical opioid consumption (OC). The secondary outcomes were pain scores (PSs) at different timepoints after surgery and the incidence of postoperative nausea and vomiting (PONV). Five RCTs involving 234 patients were selected for our analysis. Our results show that the 24h OC was drastically lower in PENG block versus FICB patients (SMD -0.60, 95% CI -1.08 to -0.11); P<0.05, I2 = 69%). At the same time, there were no significant difference in postsurgical PSs between the two cohorts (6h: MD -0.07, 95% CI -0.67 to 0.53; P = 0.82, I2 = 43%; 12h: MD -0.60, 95% CI -1.40 to 0.19; P = 0.14, I2 = 31%; 24h: MD 0.17, 95% CI -0.87 to 1.21; P = 0.75, I2 = 76%; 36h: MD 0.80, 95% CI -0.92 to 2.51; P = 0.36, I2 = 73%; 48h: MD -0.06, 95% CI -0.75 to 0.63; P = 0.86, I2 = 0%) and the incidence of PONV (RR 1.00, 95% CI 0.40-2.50, P = 1.00, I2 = 35%). Our research shows that PENG block can reduce the use of opioids after hip surgery and is effective in postoperative analgesia. Future research should explore the injection method, concentration, and dosage.