Pericapsular nerve group block combined with lateral femoral cutaneous nerve block versus fascia iliaca compartment block for hip surgery: a systematic review, meta-analysis, and trial sequential analysis.

Study Summary

6 randomized controlled trials including 442 patients undergoing hip or proximal femur surgery were included in this systematic review, meta-analysis, and trial sequential analysis comparing pericapsular nerve group block (PENG) combined with lateral femoral cutaneous nerve block (LFCN) block vs fascia iliaca compartment block (FICB). Pooled outcomes of interest included Numerical Rating Scale (NRS) for resting and dynamic pain scores, post-operative opioid consumption, quadriceps muscle strength, incidence of muscle weakness, time to ambulation, postoperative nausea and vomiting, degree of active hip flexion, perioperative analgesic efficacy and incidences of adverse effects. Outcomes were measured at baseline, 6 hours and 24 hours postoperatively. Combined PENG plus LFCN significantly reduced resting pain at 6 and 24 hours, improved quadriceps strength, reduced early muscle weakness, and shortened time to ambulation, while opioid consumption, dynamic pain, and postoperative nausea and vomiting were comparable between groups. Overall, the findings suggest that PENG combined with LFCN is a motor-sparing regional anesthesia technique that enhances early functional recovery while providing superior early postoperative analgesia compared with FICB.