Study Summary

Ninety-two patients undergoing total hip arthroplasty (THA) were randomized to receive either a PENG block with LFCN block (n=46) or an S-FICB (n=46), both using 30 mL of 0.33% ropivacaine. The primary outcome was the time to first postoperative walk. Secondary outcomes included intraoperative remifentanil consumption, postoperative hip flexion degree, muscle strength of the operative lower limb, static and dynamic pain scores, rescue analgesia use, postoperative nausea and vomiting (PONV), and nerve block-related complications. Outcomes were assessed at 6, 24, and 48 hours postoperatively. Overall, the results showed that the PENG + LFCN block group achieved significantly earlier postoperative ambulation, greater postoperative hip flexion, and better muscle strength at 6 hours compared to the S-FICB group. Differences in pain scores were only statistically significant at 48 hours. No differences were observed in opioid consumption, rescue analgesia use, or complications. These findings suggest that PENG + LFCN block is more effective in preserving postoperative mobility, making it a suitable option for enhanced recovery programs.