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Related Experiment Video

Updated: Feb 9, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Direct visualization-guided PENG block (Pericapsular nerve Group): optimizing postoperative analgesia in total hip

Maria Bautista1,2, Jacobo Triviño-Arias3, María Camila Gómez-Ayala2,3

  • 1Servicio de Ortopedia y Traumatología, Fundación Valle del Lili, Valle del Cauca, Cali, Colombia.

Journal of Orthopaedic Surgery and Research
|February 7, 2026
PubMed
Summary

Direct visualization-guided pericapsular nerve group (PENG-DV) block offers effective pain control after total hip arthroplasty (THA). This technique aids in reducing opioid use and promoting early patient mobilization.

Keywords:
Direct anterior approachPENG blockPostoperative painRegional analgesiaTotal hip arthroplasty

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Area of Science:

  • Anesthesiology
  • Orthopedic Surgery
  • Pain Management

Background:

  • The pericapsular nerve group (PENG) block is effective for postoperative pain management in total hip arthroplasty (THA).
  • Current PENG block implementation requires specialized equipment and expertise, limiting reproducibility.
  • Direct visualization-guided PENG block (PENG-DV) was developed to address these limitations.

Purpose of the Study:

  • To describe the technique of direct visualization-guided PENG block (PENG-DV).
  • To assess the outcomes of PENG-DV for postoperative pain control in THA patients.

Main Methods:

  • Retrospective cohort study of THA patients undergoing direct anterior approach (DAA).
  • Patients received PENG-DV block as part of a multimodal analgesia protocol.
  • Evaluated demographic variables, pain scores (VAS), opioid consumption, muscle strength, and ambulation within 24 hours.

Main Results:

  • 112 out of 128 patients were analyzed (60.7% female, mean age 63).
  • Median VAS scores were 2 at 12h and 3 at 24h post-surgery.
  • 83.9% ambulated by postoperative day one, with 54.5% requiring opioid rescue (mean 10mg morphine equivalent).

Conclusions:

  • PENG-DV for THA via DAA is a promising strategy for effective postoperative pain control.
  • This technique, as part of a multimodal approach, can reduce opioid consumption.
  • PENG-DV facilitates early mobilization in THA patients.