Comparison of Pericapsular Nerve Group Block and Femoral Nerve Block for Ease of Positioning During Spinal Anaesthesia in Hip Fracture Surgeries: A Prospective Randomized Controlled Trial

Background: Hip fractures often require spinal anaesthesia for surgery, but positioning for spinal anaesthesia is painful, necessitating preoperative regional nerve blocks. This study compares ultrasound-guided pericapsular nerve group (PENG) and femoral nerve block (FNB) for positioning efficacy in hip fracture patients.
Methods: In current prospective, randomized controlled trial, 70 patients with unilateral hip fractures were allocated to either PENG (n=35) or FNB (n=35) group. Pain was assessed via Numerical Rating Scale (NRS), Positioning quality was categorized by hip flexion angle (Category A: >90°, B: 60–90°, C: <60°) and rescue analgesia requirement was recorded.
Results: NRS scores were lower in the PENG group at 20 minutes (4.74 vs. 6.20, p=0.001), 30 minutes (2.80 vs. 4.83, p=0.001), and during positioning of spinal anaesthesia (1.74 vs. 2.97, p=0.001). The PENG group had better positioning quality, with Category A achieved by 20 (57.14%) patients versus 12 (34.29%) in the FNB group (p=0.036). Rescue analgesia was needed by 1 (2.86%) patient in PENG roup versus 7 (20%) patients in FNB group (p=0.027).
Conclusions: The PENG block offers superior pain relief and positioning quality for spinal anaesthesia in hip fracture patients, with less rescue analgesia required compared to FNB.