Blocking the pericapsular nerve group against the lumbar erector spinae plane for pain management following total hip replacement: A randomized controlled trial.
- 1Department of Anesthesia and Intensive Care, Assuit University, Assuit, Egypt.
- 2Department of Orthopedic Surgery, Faculty of Medicine, Assuit University, Assuit, Egypt.
Abstract
Background
Both the pericapsular nerve group block (PENG) and the lumbar erector spinae plane block (L-ESPB) are emerging regional anesthetic techniques, yet comparative data remain limited.Patients and methods
This randomized, controlled study included 60 patients undergoing THA, assigned to receive either a PENG block (n = 30) or an L-ESPB (n = 30). The primary outcome was the time to the first analgesic request. Secondary outcomes included total analgesic consumption, pain scores measured by the numeric rating scale (NRS) at rest and during movement, assessment of quadriceps motor strength, and any block-related complications. All participants were administered a standardized multimodal analgesic protocol.Findings
The PENG group demonstrated a significantly longer time to the first analgesic request compared to the L-ESPB group (12.88 ± 4.56 hour vs. 8.45 ± 3.49 hours; P < 0.001) and lower total analgesic consumption (25.84 mg ± 5.59 mg vs. 40.18 mg ± 7.89 mg; P < 0.001). Resting NRS scores were comparable early postoperatively but were significantly lower in the PENG group at 24 hours. Dynamic pain scores were consistently lower in the PENG group across all time points. Quadriceps motor weakness was more frequent in the PENG group at 6 hours (P = 0.04), but resolved completely by 12 hours. No major complications were observed in either group.Conclusion
For postoperative analgesia following THA, the PENG block is superior to L-ESPB, offering prolonged analgesia and reduced opioid requirements. Although transient quadriceps weakness may occur, it resolves early without clinical sequelae.
Related
- Effect of core stabilization exercises on balance and quality of life among patients with total knee replacement in Gaza Strip, Palestine: a randomized controlled trial
- Adjunctive effects of acupuncture and moxibustion in women with premature ovarian insufficiency receiving hormone replacement therapy: protocol for a multicenter, assessor-blinded, 2 × 2 factorial randomized controlled trial
- Long‐Term Neurodevelopmental Outcome Following Three Randomized Controlled Trials of Choline in Fetal Alcohol Spectrum Disorder (FASD)
- Effects of Hidden Conditioning and Positive Expectations on Pain Intensity Following Spinal Manipulative Therapy: A Three‐Arm Randomized Controlled Trial
- Rapidly Reversible Monitored Anesthesia Care with Remimazolam and Flumazenil Reversal for Transcatheter Aortic Valve Replacement: A Randomized Controlled Trial
BibTeX
@article{ahmed2026blocking,
title = {{Blocking the pericapsular nerve group against the lumbar erector spinae plane for pain management following total hip replacement: A randomized controlled trial.}},
author = {Ahmed T Ahmed and Abdeltwab Y Tamam and Ahmed M Abdelhafez and Ayman M Osman and Abdelraheem Elawamy and Mohammad K Abdelnasser and Hossam El-Din G Fakhry and Ayman A Abouglalah},
journal = {Saudi journal of anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/sja.sja_407_26},
url = {https://europepmc.org/article/MED/42960336},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Blocking the pericapsular nerve group against the lumbar erector spinae plane for pain management following total hip replacement: A randomized controlled trial.
AU - Ahmed T Ahmed
AU - Abdeltwab Y Tamam
AU - Ahmed M Abdelhafez
AU - Ayman M Osman
AU - Abdelraheem Elawamy
AU - Mohammad K Abdelnasser
AU - Hossam El-Din G Fakhry
AU - Ayman A Abouglalah
PY - 2026
DA - 2026/10/01
JO - Saudi journal of anaesthesia
DO - 10.4103/sja.sja_407_26
UR - https://europepmc.org/article/MED/42960336
AB - Background Both the pericapsular nerve group block (PENG) and the lumbar erector spinae plane block (L-ESPB) are emerging regional anesthetic techniques, yet comparative data remain limited.Patients and methods This randomized, controlled study included 60 patients undergoing THA, assigned to receive either a PENG block (n = 30) or an L-ESPB (n = 30). The primary outcome was the time to the first analgesic request. Secondary outcomes included total analgesic consumption, pain scores measured by the numeric rating scale (NRS) at rest and during movement, assessment of quadriceps motor strength, and any block-related complications. All participants were administered a standardized multimodal analgesic protocol.Findings The PENG group demonstrated a significantly longer time to the first analgesic request compared to the L-ESPB group (12.88 ± 4.56 hour vs. 8.45 ± 3.49 hours; P < 0.001) and lower total analgesic consumption (25.84 mg ± 5.59 mg vs. 40.18 mg ± 7.89 mg; P < 0.001). Resting NRS scores were comparable early postoperatively but were significantly lower in the PENG group at 24 hours. Dynamic pain scores were consistently lower in the PENG group across all time points. Quadriceps motor weakness was more frequent in the PENG group at 6 hours (P = 0.04), but resolved completely by 12 hours. No major complications were observed in either group.Conclusion For postoperative analgesia following THA, the PENG block is superior to L-ESPB, offering prolonged analgesia and reduced opioid requirements. Although transient quadriceps weakness may occur, it resolves early without clinical sequelae.
SN - 1658-354X
SN - 0975-3125
ER -