A Competency-Based Evaluation Checklist for the Pericapsular Nerve Group (PENG) Block: A Delphi Study

The Pericapsular Nerve Group (PENG) block is a novel, ultrasound-guided regional anesthesia technique that provides analgesia for hip surgeries by targeting the articular branches of the femoral, obturator, and accessory obturator nerves, while preserving motor function. Unlike traditional blocks used for total hip arthroplasty and femoral neck fractures, the PENG is a motor sparing block, promoting early ambulation while reducing opioid use. Despite its advantages, variability in technique and lack of standardization result in inconsistent results. This study aimed to develop and validate a competency-based checklist for PENG block performance using the Modified Delphi Method. Twenty-five regional anesthesia experts were invited to participate; 16 responded to the first survey round. A consensus of over 75% was achieved on all checklist items, particularly those related to anatomic landmarks and post-block procedures. Variability in ultrasound image acquisition techniques highlighted the need for flexibility within a standardized framework. Expert feedback was integrated to refine the checklist, ensuring clinical relevance and educational value. Establishing a validated checklist will standardize PENG block administration, leading to enhanced provider competency, improved outcomes, and reduced incidence of complications.