Patients were randomly divided into two groups to receive either ultrasound-guided
pericapsular nerve group block (PENG group) or fascia iliaca compartment block (FICB
group), using 20 ml of 0.2% ropivacaine

Quality of Recovery After Hip Fracture Surgery: US-guided PENG Block Versus FICB

Enhanced Recovery After Surgery

Participants were randomly divided into two groups : group PENG and group FICB, to
receive either ultrasound-guided pericapsular nerve group block or fascia iliaca
compartment block, using 50 ml of 0.2% ropivacaine.

For the FICB, a linear ultrasound probe was placed in the transverse plane and start
scanning at the level of the inguinal crease to identify the femoral artery medially and
the femoral nerve lateral to the femoral artery. The iliopsoas muscle should be seen
overlying fascia iliaca. The block should be performed proximal to the arterial
bifurcation. A 50 mm needle was introduced using an in-plane approach to penetrate the
fascia iliaca. The hydro dissection separate the fascia iliaca from the iliac muscle, and
a total volume of 20 ml of 0.2% ropivacaine was injected in this created space.

The PENG bloc is performed with a low frequency curvilinear ultrasound probe, which was
initially placed in a transverse plane over the antero inferior iliac spine and the
aligned with the pubic ramus by rotating the probe counterclockwise approximately 45
degrees. In this view, it is possible to observe the iliopubic eminence, the iliopsoas
muscle tendon, the femoral artery and the pectineus muscle. A 100 mm needle was inserted
from lateral to medial in an in-plane approach to place the tip in the musculofascial
plane between the psoas tendon anteriorly and the pubic ramus posteriorly. Negative
aspiration should be observed before injection of local anaesthetic and a total volume of
20 ml of 0.2% ropivacaine was injected.

Spinal anesthesia was performed after 20 minutes.

QoR-15 score was assessed before the intervention and 24 hours postoperatively.

PENG vs FICB

Quality of Recovery After Hip Fracture Surgery: Ultrasound-guided Pericapsular Nerve Group Block Versus Fascia Iliaca Compartment Block

Change in Quality of Recovery-15 (QoR-15) scores before and 24 hours after surgery.

The QoR-15 score consists of 15 items, and includes five dimensions: pain (two items),
physical confort (five items), physical independance (two items), psychological support
(two items) and emotional state (four items). Each item's score ranged from 0 to 10, and
the total score ranged from 0 to 150, with a higher QoR-15 score indicating a better
quality of recovery.

Principal Investigator

The strength of the quadriceps muscle was measured 24 hours after surgery. It was
determined by testing the movement of the knee and the hip.

change in visual analogue scale ((VAS) with 0 indicating no pain and 10 indicating the
worst imaginable pain) at rest and on movement on postoperative day 1.

Participants enrolled in this group received a pericapsular nerve group block with 20 ml
of 0.2% ropivacaine. The block was performed with a 100 mm needle, inserted with an
in-plane lateral to medial approach. Operator used a low frequency curvilinear probe.

Patients allocated in this group received a fascia iliaca compartment block with 20 mL of
0.2% ropivacaine, using a 50 mm needle inserted with an in-plane approach. Operator used
a linear probe.

Quality of Recovery After Hip Fracture Surgery: US-guided PENG Block Versus FICB

About this trial

Study ID

Status

Type

Phase

Placebo

Accepting

Not accepting

Trial Timing

What is this trial about?

What are the participation requirements?

Locations

Location

Status