Ultrasound-Guided Pericapsular Nerve Group Block vs Suprainguinal Fascia Iliaca Block for Analgesia in Hip Fracture Surgery: A Prospective Comparative Observational Study.

BACKGROUND Hip fractures cause severe perioperative pain, increased opioid use, and delayed recovery. The ultrasound-guided pericapsular nerve group (PENG) and suprainguinal fascia iliaca (SIFI) blocks are regional techniques targeting hip innervation. This study aimed to compare the effects of ultrasound-guided PENG and SIFI blocks on perioperative analgesia and clinical outcomes in hip fracture surgery. MATERIAL AND METHODS This prospective observational study included patients undergoing hip fracture surgery under spinal anesthesia. Patients received either an ultrasound-guided PENG block or a suprainguinal fascia iliaca block as part of routine clinical practice. The primary outcome was perioperative pain intensity measured using the numerical rating scale (0-10), including baseline pre-block assessments, pain during spinal positioning, and postoperative pain scores. All other variables, including ease of spinal positioning, hemodynamic parameters, cumulative 24-hour postoperative tramadol consumption, time to first analgesic requirement, range of motion of the affected limb, patient satisfaction, and adverse events, were evaluated as secondary outcomes. RESULTS A total of 67 patients were included (PENG, n=34; SIFI, n=33). The SIFI group had significantly lower pain scores in the neutral position (P=0.004), during limb elevation (P<0.001), and at 2 to 8 hours postoperatively (P<0.001). The 24-hour consumption of tramadol was lower (P=0.011), and active hip flexion at 8 hours was greater (P=0.001) in the SIFI group. Other outcomes were similar. CONCLUSIONS Both the PENG and SIFI blocks provided effective perioperative analgesia. SIFI was associated with lower pain scores at selected intervals and reduced opioid consumption; however, these findings represent time-specific associations rather than definitive superiority.