Comparison of pericapsular nerve group block and femoral nerve block in spinal anesthesia position analgesia for proximal femoral fractures in geriatric patients: a randomized clinical trial

BACKGROUND: This study aimed to compare the analgesic efficacy of the femoral nerve block (FNB) with that of the pericapsular nerve group (PENG) block in the lateral decubitus position for spinal anesthesia in geriatric hip fracture surgery. METHODS: Patients aged ≥65 years scheduled to undergo hip fracture surgery for proximal femur fractures with an American Society of Anesthesiologists physical status of class I-IV and body mass index of 18-40 kg/m2 were included in the study. The PENG block or FNB was performed 20 min before positioning for spinal anesthesia. Lateral position, hip flexion, and lumbar spine flexion pain were evaluated during spinal anesthesia. RESULTS: Sixty patients completed the study. The median pain scores for lateral positioning were 2 (0-4) and 2.5 in the PENG and FNB groups, respectively (P=0.001). The median pain scores during hip flexion were 1 (0-4) and 2.5 in the PENG and FNB groups, respectively (P<0.001). The median pain score during lumbar flexion was 1 (0-4) and 2.0 in the PENG and FNB groups, respectively (P=0.001). The two groups did not show a significant difference in the quality of the spinal anesthesia position (P>0.05). CONCLUSION: Pre-operative PENG block is more effective in reducing the pain associated with spinal anesthesia position than FNB in geriatric hip fractures. Both blocks had a similar effect on posture quality and the number of spinal interventions.