Pericapsular Nerve Group (PENG) block versus fascia iliaca compartment (FI) block for hip surgery: a systematic review and meta-analysis of randomized controlled trials

This study compares Fascia Iliaca compartment (FI) block and Pericapsular Nerve Group (PENG) block for hip surgery. Pubmed, Embase and Cochrane were systematically searched in April 2022. Inclusion criteria were: Randomized Controlled Trials (RCTs); comparing PENG block versus FI block for hip surge...

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Bibliographic Details
Published in:Brazilian Journal of Anesthesiology 2023-11, Vol.73 (6), p.794-809
Main Authors: Andrade, Priscila P., Lombardi, Rafael A., Marques, Isabela R., Braga, Anna Carla Di Napoli Andrade e, Isaias, Beatrice R.S., Heiser, Nicholas E.
Format: Article
Language:English
Subjects:
ANESTHESIOLOGY
Fascia iliaca block
Hip replacement
Hip surgery
MEDICINE, GENERAL & INTERNAL
Meta-analysis
PENG block
Pericapsular nerve group block
Review
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Summary:This study compares Fascia Iliaca compartment (FI) block and Pericapsular Nerve Group (PENG) block for hip surgery. Pubmed, Embase and Cochrane were systematically searched in April 2022. Inclusion criteria were: Randomized Controlled Trials (RCTs); comparing PENG block versus FI block for hip surgery; patients over 18 years of age; and reporting outcomes immediately postoperative. We excluded studies with overlapped populations and without a head-to-head comparison of the PENG block vs. FI block. Mean-Difference (MD) with 95% Confidence Intervals (CI) were pooled. Trial Sequential Analyses (TSA) were performed to assess inconsistency. Quality assessment and risk of bias were performed according to Cochrane recommendations. Eight RCTs comprising 384 patients were included, of whom 196 (51%) underwent PENG block. After hip surgery, PENG block reduced static pain score at 12h post-surgery (MD = 0.61 mm; 95% CI 1.12 to -0.09; p = 0.02) and cumulative postoperative oral morphine consumption in the first 24h (MD = -6.93 mg; 95% CI -13.60 to -0.25; p = 0.04) compared with the FI group. However, no differences were found between the two techniques regarding dynamic and static pain scores at 6 h or 24 h post-surgery, or in the time to the first analgesic rescue after surgery. The findings suggest that PENG block reduced opioid consumption in the first 24 h after surgery and reduced pain scores at rest at 12 h post-surgery. Further research is needed to fully understand the effects of the PENG block and its potential benefits compared to FI block. CRD42022339628 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=339628
ISSN:0104-0014
2352-2291
0104-0014
2352-2291
DOI:10.1016/j.bjane.2023.07.007