Related Experiment Video
Updated: May 28, 2025
09:51
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
2.5K
Pericapsular Nerve Group Block Plus Lateral Femoral Cutaneous Nerve Block vs. Fascia Iliaca Compartment Block in Hip
Francesco Vetrone1, Francesco Saglietti2, Andrea Galimberti3
1Department of Anesthesiology, Pain Medicine and Intensive Care Unit, Policlinico di Monza, 20900 Monza, Italy.
Journal of Clinical Medicine
|February 13, 2025
Summary
Pericapsular Nerve Group (PENG) block with Lateral Femoral Cutaneous Nerve (LFCN) offers superior pain management and less muscle weakness after total hip arthroplasty compared to Fascia Iliaca Compartment Block (FICB). This technique also reduced opioid consumption, aiding faster recovery.
Area of Science:
- Anesthesiology and Pain Management
- Orthopedic Surgery
- Regional Anesthesia
Background:
- Effective pain control and minimal muscle weakness are crucial for early physical therapy and discharge after total hip arthroplasty (THA).
- Fascia Iliaca Compartment Block (FICB) is recommended for pain relief with low motor block risk.
- Pericapsular Nerve Group (PENG) block combined with Lateral Femoral Cutaneous Nerve (LFCN) block is a proposed alternative with limited evidence regarding muscle weakness and pain control.
Purpose of the Study:
- To evaluate the degree of muscle weakness and pain control associated with PENG + LFCN block in patients undergoing THA.
- To compare the PENG + LFCN block outcomes against the established FICB technique.
Main Methods:
- Retrospective analysis of 80 patients undergoing elective THA between November 2022 and October 2023.
- Patients received either PENG + LFCN block (n=57) or FICB (n=23).
- Quadriceps femoris muscle strength was assessed using the MRC scale at 6 hours postoperatively. Pain control was measured via NRS scores at 6, 12, and 24 hours, along with opioid consumption and time to first rescue opioid.
Main Results:
- PENG + LFCN group demonstrated significantly higher MRC scores at 6 hours postoperatively (4 [4; 5] vs. 3 [2; 4], p=0.0001), indicating less muscle weakness.
- Superior pain control was observed in the PENG + LFCN group at 6, 12, and 24 hours post-surgery (p=0.0006).
- The PENG + LFCN group required significantly fewer rescue opioids (7.5 [0; 15] MME vs. 60 [40; 80], p=0.001) compared to the FICB group.
Conclusions:
- PENG + LFCN block is associated with reduced muscle weakness, enhanced pain control, and decreased opioid requirements in THA patients.
- These findings suggest PENG + LFCN as a potentially more effective regional anesthesia technique for THA.
- Further large-scale prospective studies are warranted to validate these results.
Related Concept Videos
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
352
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
352
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
571
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
571
01:19Abdominal Regions and Quadrants
7.1K
To promote clear communication, for instance, about the location of a patient's abdominal pain or a suspicious mass, anatomists and clinicians typically use imaginary lines to categorize the abdominopelvic cavity into either four quadrants or nine regions to identify organs in the cavity.
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
7.1K
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
933
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
933