Comparative Study between PENG (Pericapsular Nerve Group Block) and Supra-Inguinal Fascia Iliaca Block (SIFIB) for Positioning and Post Operative Analgesia in Hip Arthroplasty Operations: A Prospective Randomized Comparative Clinical Study

Abstract

Background: Effective pain management is crucial in hip arthroplasty for patient recovery and satisfaction. Objective: This study aimed to compare the analgesic efficacy of ultrasound-guided pericapsular nerve group block (PENG) with supra-inguinal fascia iliaca block (SIFIB) for both intraoperative positioning and postoperative pain relief. Subjects and Methods: A prospective, randomized, observer-blinded study at Benha University Hospitals. The study involved 60 patients who were scheduled for unilateral hip arthroplasty, divided equally to receive either PENG or SIFIB. The study assessed pain using the Visual Analogue Scale (VAS) at multiple post-block and postoperative intervals, time to first mobilization, morphine consumption, block failure rates, and patient satisfaction. Results: The PENG group showed significantly lower VAS scores during positioning (2.96 ± 0.718 vs. 3.43 ± 6.26, p=0.01) and earlier mobilization (111.43 ± 12.23 min vs. 133.83 ± 21.99 min, p < 0.001) compared to the SIFIB group respectively. There were no significant differences in postoperative VAS scores or morphine consumption between the groups. Patient satisfaction was higher in the PENG group (50% reporting good satisfaction vs. 26.7% in SIFIB, p=0.041). Conclusion: PENG block provided better analgesia for patient positioning and facilitated earlier postoperative mobilization with higher satisfaction compared to SIFIB in hip arthroplasty patients. Both blocks were similarly effective for postoperative pain management.