The effect of preoperative ultrasound-guided pericapsular nerve group block on postoperative analgesia after shoulder arthroscopic surgery

Background The pericapsular nerve group (PENG) block is a localized anesthetic for postoperative shoulder analgesia, performed under ultrasound, targeting only sensory branches, excluding posterior mechanoreceptors. Aim The objective of this study was to assess the effectiveness of preoperative ultrasound-guided PENG in managing postoperative pain following shoulder arthroscopic surgery. Patients and methods This prospective, randomized, controlled, double-blind trial involved 60 adult participants, aged between 21 and 65 years, scheduled for unilateral shoulder arthroscopic procedures. The participants were allocated into two groups: Control group: received a sham PENG block with only 1 ml of saline, and the PENG group: received the actual PENG block containing 15 ml of 0.25% bupivacaine combined with 0.2 mg/ml of dexamethasone. Results The time taken for initial administration of rescue pain relief in group II was significantly longer than in group I, with a significant difference of P =0.001. There was a significant decrease in morphine consumption in group II in comparison with group I. The four-point satisfaction rating showed a significant difference in joint mobility and exercise duration between the PENG and control groups. Patients in the PENG group had significantly lower rates of postoperative nausea and vomiting compared with the control group. However, there was no significant difference in rotator cuff muscle strength between the two groups immediately after surgery or at 3, 6, 9, and 12 h postoperatively. Conclusions Preoperative ultrasound-guided PENG block in shoulder arthroscopy reduces pain, morphine use, rescue analgesia need, nausea/vomiting, and improves satisfaction, without impacting rotator cuff strength.