Pericapsular nerve group block: Innovation or just a fad?

Regional blocks such as fascia iliaca block (FIB), 3-in-1 block, femoral nerve (FN) block, and lumbar plexus block are frequently used as a part of anesthetic care plan for various hip joint procedures for their opioid-sparing effects and to provide postoperative pain relief.[1-3] However, none of the above-mentioned blocks are ideal as the articular branches of sciatic nerve to hip joint are spared. Moreover, weakness due to quadriceps femoris (QF) muscle involvement often impedes mobility in the immediate postoperative period, and questions are raised in the literature about the involvement of obturator nerve (ON) with the first two peripheral nerve blocks.[2,3]

[1]  Sergio Orozco,et al.  Pericapsular Nerve Group (PENG) block for perioperative pain control in hip arthroscopy. , 2020, Journal of clinical anesthesia.

[2]  C. Pradhan,et al.  Total postoperative analgesia for hip surgeries, PENG block with LFCN block , 2019, Regional Anesthesia & Pain Medicine.

[3]  J. J. Moser,et al.  Inadvertent quadriceps weakness following the pericapsular nerve group (PENG) block , 2019, Regional Anesthesia & Pain Medicine.

[4]  H. Otake,et al.  Pericapsular nerve group (PENG) block is effective for dislocation of the hip joint. , 2019, Journal of clinical anesthesia.

[5]  Tuhin Mistry,et al.  PENG block: points to ponder , 2019, Regional Anesthesia & Pain Medicine.

[6]  B. Moriggl,et al.  Spread of injectate around hip articular sensory branches of the femoral nerve in cadavers , 2018, Acta anaesthesiologica Scandinavica.

[7]  K. Chin,et al.  Pericapsular Nerve Group (PENG) Block for Hip Fracture , 2018, Regional Anesthesia & Pain Medicine.

[8]  A. Agur,et al.  Anatomic Study of Innervation of the Anterior Hip Capsule: Implication for Image-Guided Intervention , 2017, Regional Anesthesia & Pain Medicine.

[9]  M. Parker,et al.  Peripheral nerve blocks for hip fractures. , 2017, The Cochrane database of systematic reviews.

[10]  T. Vail,et al.  Regional anesthesia in hip surgery. , 2005, Clinical orthopaedics and related research.

[11]  X. Capdevila,et al.  Comparison of Continuous 3-in-1 and Fascia Iliaca Compartment Blocks for Postoperative Analgesia: Feasibility, Catheter Migration, Distribution of Sensory Block, and Analgesic Efficacy , 2003, Regional Anesthesia & Pain Medicine.