Comparative Study of Pericapsular Nerve Group (PENG) Block vs Suprainguinal Fascia Iliaca Compartment Block (SIFICB) in Fracture Neck of Femur in Geriatric Patients

Objective: Fracture neck of femur represents a major clinical challenge in the geriatric population, and effective perioperative analgesia is essential for optimal recovery.Peripheral nerve blocks such as the suprainguinal fascia iliaca compartment block (SIFICB) and pericapsular nerve group (PENG) block offer promising opioid-sparing alternatives.The aim of this study was to compare quadriceps muscle strength preservation and analgesic efficacy between two blocks.Method: This randomized study included 50 patients aged >60 years (ASA I/II) scheduled for fracture neck of femur surgery.Participants were randomly allocated into two groups (n=25 each).Group A received an ultrasound-guided PENG block (20 mL 0.25% levobupivacaine with 4 mg dexamethasone), while Group B received an ultrasound-guided SIFICB (40 mL 0.25% levobupivacaine with 4 mg dexamethasone).The primary outcome was quadriceps muscle strength at 6 hours postoperatively.Results: Baseline demographic and clinical characteristics were comparable between the groups.At 3 hours postoperatively, Medical Research Council (MRC) grade ≥4 quadriceps muscle power was achieved in 92% of patients in the PENG group compared with 32% in the SIFICB group (p=0.0011).At 6 hours, grade 5 muscle power was observed in 72% and 32% of patients, respectively (p=0.0039).No statistically significant differences were observed in pain scores at 6, 12, or 24 hours postoperatively.Rescue analgesia was required in 32% of patients in the PENG group and 52% in the SIFICB group (p=0.15).Postoperative nausea and vomiting occurred in 4% and 12% of patients, respectively (p=0.61).