Comparison of pericapsular nerve group block versus supra-inguinal fascia iliaca block on postoperative pain management, quadriceps muscle strength, and early functional outcomes after arthroscopic treatment of femoroacetabular impingement: a prospective, randomized clinical study.

Abstract

This study compared the effects of pericapsular nerve group (PENG) block and supra-inguinal fascia iliaca compartment block (FICB) on quadriceps strength, postoperative analgesia, and functional scores following hip arthroscopy (HA) for patient complaining of femoroacetabular impingement (FAI) under general anaesthesia. A prospective, randomized, and controlled trial recruited a total of 48 patients who had either PENG group or supra-inguinal FICB as a pain management modality. The primary outcomes were the postoperative quadriceps muscle power, and the secondary outcomes included pain scores, opioid consumption, and functional scores; the modified Harris hip score (mHHS) and international hip outcome tool-12 (iHOT-12) score. All patients in PENG group were capable of performing a straight leg raise with hip flexion of >15°. In contrast, two patients in FICB group had postoperative falls and six patients (25%) were unable to perform a straight leg raise at 24 h postoperatively. At the time of admission to the post-anaesthesia care unit and at 6, 12, and 24 h postoperatively, peak visual analogue scale (VAS) scores at rest were 6, 5, 4, and 4, respectively, in PENG group and 8, 7, 6, and 5, respectively, in FICB group (<i>P</i> < .001). Total opioid consumption in the 24 h postoperatively was lower in the PENG group compared to the FICB group (mean, 18.5 ± 9.4 versus 26.8 ± 9.6; <i>P</i> < .05). Significant improvement was observed (6 and 12 months postoperatively) regarding iHOT-12 score in the PENG group (70 ± 24.33, 82.85 ± 11.45) compared to the FICB group (59.04 ± 22.66, 64.1 ± 17.42) (<i>P</i> = .02, <i>P</i> < .001, respectively).