Different local anesthetic volumes in pericapsular nerve group block for hip fracture patients

The pericapsular nerve group (PENG) block is an effective method for pain management in patients with hip fractures. In our study, we compared three different local anesthetic volumes of the PENG block in patients who underwent surgery for hip fracture.

Patients who underwent surgery with spinal anesthesia for intertrochanteric femur fractures (60 patients) were divided into three groups based on the volume of local anesthetic administered: Group 1 (20 mL), Group 2 (30 mL), and Group 3 (40 mL). Postoperative patient-controlled analgesia was initiated. Postoperative tramadol consumption, rest and movement pain scores, and the duration of motor block were monitored.

We found that Group 2 (118 ± 35.48 mg) and Group 3 (115 ± 42.98 mg) had reduced tramadol consumption compared to Group 1 (151 ± 31.43 mg) (p < 0.05). However, Group 3 (161 ± 18.6 min) had a longer duration of motor block (time to reach a Bromage score of 0) compared to Group 1 (132.25 ± 13.71 min) and Group 2 (143.5 ± 19.54 min) (p < 0.05).

We found that the 30 mL and 40 mL volumes in the PENG block resulted in lower tramadol consumption compared to the 20 mL volume. We believe that the 30 mL volume is the most appropriate option among the three volumes, as it provides similar analgesic efficacy to the 40 mL volume but causes less motor block.