Comparison between pericapsular nerve group block and fascia iliaca compartment block for perioperative pain control in hip surgeries: A meta-analysis from randomized controlled trials

Background To alleviate pain related to hip surgeries, pericapsular nerve group block (PENG) is introduced as an innovative approach aims to improve analgesia without interfering with muscle motor activity. In this study, we compared the effectiveness and safety of PENG block to fascia iliaca compartment block (FICB) for managing acute pain related to hip operations. Methods Systematically looking through electronic databases, we only included randomized controlled trials (RCTs) involving hip surgeries. The perioperative pain scores at various time periods, postoperative narcotic demands in 24 h, the time of first opioid request, quality of patient positioning during spinal anesthesia (SA), patients' satisfaction, and adverse event incidence between the two groups were obtained through the study. Results The analysis included nine RCTs with a total of 524 patients. Compared to the FICB, PENG significantly reduced the pain scores early at 30 min post-block during positioning for SA (SMD = -0.98, 95% CI: -1.76 to -0.20, P = 0.01), improved the quality of positioning, and enhanced patient satisfaction. However, no significant differences were observed between PENG and FICB regarding pain scores postoperatively at different time periods during rest and exercise. Patients in the FICB group had more narcotic demands at 24 h post-surgical (MD = -8.09, 95% CI: -14.25 to -1.93, P = 0.01). Otherwise, no differences were detected regarding the time of first opioid request, postoperative complications, or length of hospitalization. Conclusions PENG offered better benefits in terms of reducing pain, while the patient is being positioned for SA and minimizing narcotic consumption over the first 24 hours following hip surgeries.

Automated summary

This study compared the effectiveness and safety of PENG and FICB for managing acute pain related to hip surgeries. The results showed that PENG significantly reduced pain scores, improved patient satisfaction, and decreased the use of narcotic drugs compared to FICB. However, there was no significant difference in pain scores between the two methods during rest and exercise at different time periods postoperatively.