Pericapsular Nerve Group Block Versus Femoral Nerve Block for Analgesia in Newly Admitted Patients With Hip Fractures

Objectives: To compare the effects of preoperative pericapsular nerve group (PENG) block versus femoral nerve block (FNB) on pain in patients with hip fractures. Methods: Sixty eligible patients were randomized (1:1) to receive PENG block or FNB. The primary endpoint was post-block pain assessed via Visual Analogue Scale (VAS). Secondary endpoints included time to optimal ultrasound imaging, procedure duration, time to first rescue analgesic, 24-hour rescue analgesic consumption, postoperative recovery quality, vital signs, and adverse events. Results: At 30 minutes post-block, both resting VAS scores (0.0 [0.0, 1.2] vs. 1.1 [0.6, 1.8], P =0.020) and passive movement VAS scores (2.9 [1.7, 3.6] vs. 3.4 [2.7, 4.7], P =0.027) were significantly lower in the PENG group compared with the FNB group. At 12 hours post-block, resting VAS (3.0 [2.1, 4.0] vs. 2.3 [1.7, 2.6], P =0.006) and passive movement VAS (6.8 [5.1, 7.3] vs. 4.9 [4.1, 5.8], P =0.002) were higher in the PENG group. The PENG group achieved optimal ultrasound imaging faster, had an earlier time to first rescue analgesic, and required a greater total dose of rescue analgesics within 24 hours (all P <0.001). Procedure duration, vital signs, and recovery quality did not differ significantly. Discussion: PENG blocks outperform FNB in imaging speed and early pain control but yield a shorter block duration, thereby increasing 24-hour rescue analgesic demands.