The PENG Block in Elective Primary Anterior Total Hip Arthroplasty Is Associated with Reduced Length of Stay: A Multidisciplinary Prospective Randomized Double-Blinded Controlled Trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(11):7 J Bone Joint Surg Am . 2025 Apr 16;107(8):805-810.What this means for my practice?
Clinicians should remember that a PENG block during primary anterior THA significantly shortens hospital stay without impacting immediate postoperative pain or opioid consumption. This suggests that the PENG block may enhance recovery protocols and streamline discharge planning in this setting. However, the study's limitations include being underpowered for detecting morphine consumption differences and variability in anesthesia provider experience.
Study Summary
Sixty patients undergoing primary anterior total hip arthroplasty for osteoarthritis or osteonecrosis of the femoral head were randomized to receive either a PENG block with ropivacaine (n=32) or a placebo injection with saline (n=28). The primary outcome was the visual analogue scale (VAS) pain score at 1, 6, 12, and 24 hours postoperatively. Secondary outcomes included total morphine-equivalent dose consumption in the first 24 hours and length of stay (LOS). Overall, the results of the study revealed no significant difference in postoperative VAS pain scores or morphine consumption between the groups, but a significantly shorter LOS in the PENG group. This suggests that while the PENG block does not affect immediate postoperative pain or opioid consumption, it does result in a significantly shorter hospital stay.
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