The Use of Pericapsular Nerve Group (PENG) Block in Hip Surgeries Is Associated With a Reduction in Opioid Consumption, Less Motor Block, and Better Patient Satisfaction: A Meta-Analysis.

Abstract

Pericapsular nerve group (PENG) block has been successfully utilized as an optional regional anesthesia approach to manage the pain for hip surgeries without affecting motor function. During recent years, the applications of PENG block are expanding. There is one previous review on PENG block for hip surgeries in the scientific literature and it is limited to case series and case reports only. We found few randomized controlled trials related to the role of PENG block in recent literature. So, a meta-analysis was done to evaluate the role of PENG block in managing postoperative pain after hip surgeries.We followed PRISMA guidelines to perform this meta-analysis. Online databases including Medline and ScienceDirect were used. This review was registered with the PROSPERO database (CRD42022297694) in January 2022. The included studies in this review reported opioid use, pain control after surgery, and side effects associated with PENG block among patients undergoing hip surgeries. The Review Manager software, i.e. RevMan for Mac 5.4 (Cochrane Collaboration, Oxford, UK) was utilized to conduct a meta-analysis.During this meta-analysis, six randomized trials were included. Our results demonstrated that PENG block usage for patients undergoing hip surgery is correlated with a significant reduction in opioids in the first 24 h after surgery (p=0.05). It also resulted in significant prolongation of time to first request analgesia with mean difference as 3.82 h (0.05-7.60), (p=0.05). Our results showed that PENG block is associated with better patient satisfaction as well. The PENG block resulted in less motor block in the postoperative period (p=0.0002). In conclusion, PENG block can significantly reduce 24-h opioids consumption after hip surgery. This block also resulted in prolonged time to first request of analgesia postoperatively. There is less risk of motor block and hence the potential for better physiotherapy.