Surgeon-Performed Intraoperative Pericapsular Nerve Group Block in Total Hip Replacement: A Cadaveric Feasibility...

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Anatomy

Background:

• The pericapsular nerve group (PENG) block is an effective regional anesthesia technique for hip surgery, aiding pain management and mobility.
• Current PENG block implementation varies, prompting exploration of alternative delivery methods.

Purpose of the Study:

• To assess the anatomical feasibility of intraoperative PENG block placement by surgeons.
• To compare surgeon-placed PENG block needle position with the standard ultrasound-guided technique.

Main Methods:

• A cadaveric feasibility study using a fresh-frozen lower limb.
• Anesthesiologist performed ultrasound-guided PENG block, followed by surgeon-placed PENG block via a posterolateral approach.
• Needle positions were compared via direct surgical visualization.

Main Results:

• Both needles occupied the same myofascial plane between the iliopsoas tendon and pubic ramus.
• The intraoperative needle was positioned less than 1 cm from the ultrasound-guided needle.
• No damage to surrounding neurovascular structures was observed.

Conclusions:

• Intraoperative PENG block placement by surgeons using a posterior approach is anatomically feasible.
• This technique accurately replicates the target plane of the conventional ultrasound-guided PENG block.
• Further in vivo research is needed to confirm clinical effectiveness and safety.