Different Volumes of Pericapsular Nerve Group Block on Pain in Femoral Fracture Surgeries .
Impact of Different Volumes of Pericapsular Nerve Group Block on Pain During Spinal Anesthesia Positioning and Postoperative Opioid Requirements in Femoral Fracture Surgeries; Randomized Prospective Study.
J Pain Res . 2024 Sep 18:17:3075-3084.Sixty patients undergoing femoral fracture surgery were randomized to receive a PENG block with either 20 mL (n=30) or 30 mL (n=30) of local anesthetic. The primary outcome was pain during spinal anesthesia positioning, measured using the Numeric Rating Scale (NRS). Secondary outcomes included postoperative NRS pain scores and cumulative opioid requirements within the first 24 hours. Quadriceps weakness was assessed postoperatively. Results showed no significant differences in NRS scores during spinal anesthesia positioning (p=0.247) or overall opioid consumption at 24 hours (p=0.098). However, quadriceps weakness was more common in the 30 mL group at 6 hours (p=0.004), resolving by the 9th hour. Overall, the study revealed that increasing the volume of PENG block to 30 mL did not provide additional pain control benefits and was associated with transient motor weakness. These findings suggest that 20 mL of local anesthetic is sufficient for effective pain management without compromising early mobilization.
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