Related Experiment Video
Updated: Mar 24, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Combined Pericapsular Nerve Group (PENG) and Ilioinguinal-Iliohypogastric Blocks for Pediatric Pelvic Osteotomy: A
Rayan Muawad1, Abdullah AlDhuwaihy2, Khalid Alanezi2
1Pediatric Anesthesia, King Abdullah Specialist Children Hospital, Ministry of National Guard Health Affairs (MNGHA), Riyadh, SAU.
Abstract:
The pericapsular nerve group (PENG) block is a regional anesthesia technique that targets the articular branches innervating the anterior hip capsule, offering effective analgesia with minimal motor blockade. While its utility in hip surgery is established, its solitary use in pediatric pelvic osteotomies leaves the cutaneous incision site uncovered. We report the case of a 21-month-old male with significant cardiopulmonary comorbidities undergoing a unilateral pelvic osteotomy. To minimize respiratory and hemodynamic risks associated with opioids, a multimodal, opioid-sparing analgesic strategy was implemented. This approach combined an ultrasound-guided PENG block with an ipsilateral ilioinguinal-iliohypogastric nerve block to ensure comprehensive coverage of both deep articular and superficial somatic pain. The intraoperative course was stable, and the patient demonstrated excellent postoperative analgesia with no requirement for rescue opioids. This case highlights that supplementing the PENG block with an ilioinguinal-iliohypogastric block provides a tailored, anatomical solution for pediatric pelvic osteotomy, offering a safe and effective regional anesthesia strategy for high-risk pediatric patients.
Related Concept Videos
Spinal Nerves: Plexus II
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...
Abdominal Regions and Quadrants
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...
Muscles of the Pelvic Floor and Perineum
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
Spinal Nerves: Plexus I
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...

