ArticleJournal of pain research2025
Pericapsular Nerve Group Block in Combination with Lateral Femoral Cutaneous Nerve and Sacral Plexus Blocks for Hip Fracture: A Case Series.
Article in Journal of pain research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Regional anesthetic techniques for hip fracture are critical for pain control, reducing perioperative adverse events, and minimizing postoperative opioid use. This case series investigates the use of a novel triple-block protocol-ultrasound-guided pericapsular nerve group (PENG) block, lateral femoral cutaneous nerve (LFCN) and sacral plexus blocks-in patients with hip fractures, focusing on its feasibility as an anesthetic strategy for high-risk hip fracture patients. Case Presentation: Five frail elderly patients with significant comorbidities and contraindications to neuraxial anesthesia underwent bipolar femoral head replacement surgery. Primary outcomes included anesthesia quality (0-3 scale: poor, acceptable, good, excellent) and postoperative analgesia. Secondary outcomes encompassed surgical conditions, complications, and patient satisfaction. Results: These combined blocks provided effective analgesia (Visual Analog Scale, [VAS] scores of 0-1 at PACU discharge) and preserved quadriceps motor function (Medical Research Council [MRC] scale 4-5). Surgical conditions were rated "excellent" in four cases and "acceptable" in one. Postoperative sufentanil consumption was low (36-83 μg via patient-controlled analgesia [PCA]). Complications included one case of surgical site dehiscence (requiring reoperation) and transient dizziness. Conclusion: This triple-block technique offers comprehensive analgesia for high-risk hip fracture patients or those with contraindications to neuraxial anesthesia, enabling early mobilization and reducing opioid reliance. Larger randomized trials are warranted to confirm these findings.
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