International journal of clinical practice
March 13, 2024 · via Europe PMC
Efficacy and Safety of Pericapsular Nerve Group Block for Hip Fracture Surgery under Spinal Anesthesia: A Meta-Analysis.
Li S, An J, Qian C, Wang Z
AI summary — for doctors, generated from the abstract only
A meta-analysis of 15 randomized trials found that pericapsular nerve group (PENG) block reduced pain during spinal anesthesia positioning and postoperatively, lowered rates of postoperative leg weakness, and sped up time to first walking after hip fracture surgery.
What was studied
A meta-analysis (registered on INPLASY, searches through May 1, 2023) of 15 randomized controlled trials (890 patients) evaluating the efficacy and safety of pericapsular nerve group (PENG) block for hip fracture surgery performed under spinal anesthesia, pooling data on pain scores, postoperative hypokinesia, and time to first walking.
Key findings
- PENG block reduced pain scores during spinal anesthesia positioning (SMD -0.35, 95% CI -0.67 to 0.02, P=0.04, I²=0%), with subgroup analyses showing reduced pain at 12, 24, and 48 hours postoperatively compared with no block.
- The incidence of postoperative hypokinesia (leg weakness) was reduced with PENG block (RR 0.11, 95% CI 0.01-0.86, P=0.04, I²=0%).
- Time to first walking was advanced (earlier) with PENG block (SMD -0.90, 95% CI -1.17 to -0.63, I²=0%), described as statistically significant (exact p-value not available in the provided abstract text, which appears truncated).
Clinical relevance
This may be directly relevant to anesthesiologists and orthopedic surgeons managing hip fracture surgery, supporting PENG block as a technique that can improve patient comfort during spinal anesthesia positioning, reduce postoperative muscle weakness, and facilitate earlier mobilization, which is particularly valuable in this often frail, elderly patient population.
Who should care
Limitations
Meta-analysis combines 15 trials of varying size and design; low I² values suggest consistency across studies, but publication bias and study-level quality were not detailed in this abstract; the pain score reduction during positioning had a confidence interval crossing zero at the upper bound, suggesting some uncertainty in that specific effect.
PENG nerve block appears to reduce pain and improve mobility recovery after hip fracture surgery performed under spinal anesthesia, supporting its use as a complementary technique in this setting.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
OBJECTIVE
To evaluate the effectiveness and safety of pericapsular nerve group (PENG) block for hip fracture surgery under spinal anesthesia.
METHODS
This meta-analysis was registered on INPLASY (INPLASY202270005). PubMed, Embase, Cochrane, CNKI, and Wanfang databases were searched to collect the randomized controlled trials of the PENG block applied to hip fracture surgery in the setting of spinal anesthesia, with the search period from inception to 1 May 2023. Two independent researchers gradually screened the literature, evaluated the quality, extracted the data, and eventually pooled data using RevMan 5.4.
RESULTS
Fifteen articles with 890 patients were enrolled. The combined results showed that the PENG block reduced pain scores during position placement (SMD = -0.35; 95% CI [-0.67, 0.02];=0.04; = 0%). Subgroup analyses showed that compared to the unblocked group, the PENG block reduced pain scores at 12 h, 24 h, and 48 h postoperatively. The incidence of postoperative hypokinesia was reduced (RR = 0.11; 95% CI [0.01, 0.86];=0.04; = 0.00%). The time to first walking was advanced (SMD = -0.90; 95% CI [-1.17, 0.63];< 0.00001; = 0%).
CONCLUSION
The PENG block can reduce postoperative pain and pain during spinal anesthesia positioning, which is helpful to improve the operability and comfort of spinal anesthesia and facilitate postoperative muscle strength recovery and early activity.
DOI
10.1155/2024/6896066
PMID
38510561
PMCID
PMC10954362
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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