Pericapsular nerve group with lateral femoral cutaneous nerve block vs. suprainguinal fascia iliaca block for analgesia in total hip arthroplasty: a prospective comparative study
Abstract
BACKGROUND: To comparepostoperative analgesia, opioid consumption, and early motor function between suprainguinal fascia iliaca block (SFIB) and pericapsular nerve group block combined with lateral femoral cutaneous nerve block (PENG+LFCN) in patients undergoing primary total hip arthroplasty (THA) under general anesthesia. METHODS: In this single-center, prospective, non-randomized study, 48 adults undergoing posterolateral THA received either SFIB (0.25% bupivacaine 40 mL) or PENG+LFCN (0.5% bupivacaine 15 mL + 5 mL). Primary outcomes were pain scores measured using a visual analog scale (VAS) at rest and during movement at 3, 12, 24, and 48 h. Secondary outcomes included morphine use via patient controlled analgesia, quadriceps strength and physiotherapy participation. Exploratory analyses summarised total pain burden using area under the curve (AUC, 3–48 h) and time-weighted average pain (TWAP), with inverse probability of treatment weighting (IPTW) used as a sensitivity analysis. RESULTS: Rest VAS at 24 h was lower with SFIB (1.25) vs. PENG+LFCN (2.46): mean difference 1.21 (95% CI 0.31–2.10), p = 0.017. Morphine use at 12–24 h was lower with PENG+LFCN (0.75 vs. 1.88 mg): −1.13 mg (95% CI − 2.07 to − 0.18), p = 0.027; total 0–48 h consumption was similar (p = 0.114). Quadriceps weakness at 6 h was less frequent with PENG+LFCN (29.2% vs. 54.2%; OR 0.35, 95% CI 0.11–1.15), but this difference was not statistically significant; all patients recovered full strength by 24 h.…
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Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 48 participants or records.
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