Continuous PENG block for hip fracture: a case series

Area of Science:

• Regional Anesthesia
• Pain Management
• Orthopedic Surgery

Background:

• The pericapsular nerve group (PENG) block is an emerging regional anesthesia technique for hip joint pain.
• Continuous infusions via PENG blocks are being explored for sustained analgesia.

Purpose of the Study:

• To describe the initial experience of continuous PENG block catheter infusions for pain management in patients with femur fractures.
• To assess the efficacy and identify potential adverse events associated with continuous PENG blocks.

Main Methods:

• A case series involving 10 patients with femur fractures who received continuous PENG blocks upon hospital admission.
• Catheter insertion was performed, and initial placement issues (blood aspiration) were managed by repositioning.
• Postoperative Doppler scans were used to exclude vascular structures deep to the iliopsoas muscle.

Main Results:

• All 10 patients reported good pain relief, with significant reduction in Numerical Rating Scale (NRS) scores from a median of 7 to 2 within 20 minutes.
• Sustained pain relief was observed over 48 hours post-catheter placement.
• Three patients initially experienced blood aspiration, which was resolved by repositioning the catheter; no hematomas were reported.

Conclusions:

• Continuous PENG blocks appear effective for managing hip joint pain in femur fracture patients.
• A potential risk of intravascular catheter placement was noted, necessitating further research to determine if it's a technical error or a complication.
• The study highlights the importance of careful catheter placement and monitoring in this anatomical region.