Analgesic Efficacy of Suprainguinal Fascia Iliaca Compartment Block (SFICB) vs Combined Pericapsular Nerve Group (PENG) Block with Lateral Femoral Cutaneous Nerve Block (LFCN) in Hip Surgery
DOI:
https://doi.org/10.62848/bjpain.v3i2.7073Keywords:
Ultrasound guided regional blocks, suprainguinal fascia iliaca compartment block, pericapsular nerve group block, Analgesia, Hip SurgeryAbstract
Background: Pain management for hip fracture is challenging due to complex anatomical variations and patient positioning during surgery. Though various modalities of regional techniques are being used for pain management, none of them has proven superiority. Recently fascia iliaca compartment block and pericapsular nerve group block have drawn lots of attention due to simplicity and superior pain control. In this study suprainguinal fascia iliaca compartment block (SFICB) was compared with pericapsular nerve group (PENG) block in combination with lateral femoral cutaneous nerve (LFCN) block to evaluate the analgesic efficacy and utility in fracture neck femur patients.
Methods: This prospective study was conducted from January 2022 to December 2022. Total 40 patients were allocated in two groups, suprainguinal fascia iliaca compartment block (Gr-F) or PENG with LFCN block (Gr-P) group. 30 minutes after performing the block, pain was assessed with NPRS scale during positioning for combined epidural anaesthesia. Then pain assessment was done 2 hour for first 12 hours followed by 4 hour in following 12 hours. Haemodynamic profile, duration of analgesia and requirement of rescue analgesics were recorded.
Results: During positioning of the patient for central neuraxial block, NPRS was (2.5 ± 0.3) for Gr-P and (4.5 ± 0.6) for Gr-F with p = 0.039. For Gr-F, 20% patient required Dexmedetomidine infusion during positioning. The onset of analgesia in Gr-P was (10.56 ± 3.46) minutes and in Gr-F was (15.86 ± 3.3) minutes with p < 0.05. Duration of analgesia during active movement was 14.6 (±1.09) hours for Gr-P and 10.2 (±2.06) hours for Gr-F with p value < 0.05.
Conclusion: Combination of PENG with LFCN block provides a superior analgesia characterised by early onset action, less pain score at rest and on movement during positioning of the patient and prolong duration of action on active movement postoperatively.
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