Pericapsular nerve group block combined with lateral femoral cutaneous nerve block for hip surgery: a meta-analysis

The combination of the pericapsular nerve group (PENG) block and lateral femoral cutaneous nerve (LFCN) block has garnered increasing attention as a postoperative analgesic strategy following hip surgery. Nevertheless, the clinical efficacy of this approach remains a subject of ongoing debate. Through a meta-analysis, the effects of the combined PENG and LFCN block in patients who underwent hip surgery were investigated.

We conducted a systematic search of relevant clinical randomized controlled trials (RCTs) available in English via online databases and grey literature resources. Quantitative analyses were performed to assess pain scores, time to first rescue analgesia, consumption of rescue analgesics, incidence of quadriceps weakness, time to first ambulation, and postoperative nausea and vomiting (PONV) to comprehensively evaluate the effects of the combined PENG and LFCN block in patients after hip surgery.

A total of 12 RCTs involving 823 patients were included in this study. The findings from the quantitative synthesis indicate that the combined PENG and LFCN block significantly decreases postoperative pain scores at rest (p < 0.001) and during movement (p = 0.021), increases the time to first rescue analgesia (p < 0.001), and reduces the consumption of rescue analgesics (p < 0.001). Additionally, this combination decreases the incidence of quadriceps weakness (p < 0.001), shortens the time to first ambulation (p < 0.001), and decreases the incidence of PONV (p = 0.020).

The combined PENG and LFCN block has favourable clinical efficacy for postoperative analgesia in hip surgery patients and is recommended for use. However, more high-quality, large-scale RCTs are needed to further validate our findings.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251142338, PROSPERO CRD420251142338.