Comparison of pericapsular nerve group (PENG) block with fascia iliaca compartment block (FICB) in hip fractures: a systematic review and meta-analysis of randomized controlled trials

Background The purpose of the study is to evaluate and compare the effectiveness of two different anesthesia techniques, PENG block and fascia iliaca compartment block (FICB), in managing pain and minimizing side effects for patients undergoing hip fracture surgery. Due to increasing numbers of patients with comorbidities, anesthesia for hip fractures has become a significant challenge. Methods From the initiation of the study until April 26, 2022, a comprehensive search was conducted across several electronic databases, including PubMed, Embase, Cochrane Library, CNKI, and WanFang Data, to identify relevant studies. The focus of the search was randomized controlled trials (RCTs) that compared the clinical efficacy of PENG block and FICB in hip fracture surgery. To ensure the validity of the study, two independent reviewers applied the standards of the Cochrane systematic review to evaluate and index all the papers. In case of heterogeneity between studies, a random-effects model was utilized, and a fixed-effects model was employed otherwise. Results According to the combined data, PENG block can decrease 24-hour postoperative opioid consumption (P༜0.05), but its 48-hour postoperative opioid consumption is not significantly different from control group (CI [-12.27, 2.79], P = 0.22). There are also no differences in side effects (CI [0.13,4.57], P = 0.76) and dynamic or static pain scores (P༞0.05) . Conclusions The results of the meta-analysis indicate that PENG blocks are effective in reducing opioid consumption for 24 hours post-hip fracture surgery. This implies that PENG blocks may be a promising alternative for reducing pain and minimizing the risk of substance abuse in patients. However, to establish this with certainty, more research with larger sample sizes and longer-term follow-up in the form of prospective randomized controlled trials is necessary.