ESRA19-0060 Efficacy of continuous pericapsular nerve group (PENG) block for pain relief after hemiarthroplasty of the hip: a case report

Background and aims The pericapsular nerve group (PENG) block has been recently described and gathered good results in acute pain relief for hip fracture. Local anaesthetic reaches the musculofascial plane between the psoas tendon and the pubic ramus, targeting the regional block of the accessory obturador nerve branches, obturador and femoral nerve. Hip fracture is a common orthopedic pathology in the geriatric population and this technique can be used to provide effective analgesia without causing motor block. Methods An 85-year-old woman, ASA III, with a subcapital hip fracture was submitted to hemiarthroplasty after subarachnoid anesthesia was conducted. At the end of the surgery, we performed an ultrasound-guided PENG block with a curvilinear probe and placed a catheter for continuous infusion of Ropivacaine 0,375% during 48 hours. Additionally she was administered paracetamol 1 gram three times a day. We followed-up the patient in the subsequent 2 days and evaluated both pain control and motor block. On the third day the catheter was removed. Results During the 2-day follow-up, the patient had a pain score from 0 to 2 and did not require any additional analgesia. There was no motor block or complications documented. Conclusions Continuous PENG block can be an effective option to provide analgesia 48 hours postoperatively in patients with femur fracture, reducing consumption of opioids and nonsteroidal anti-inflammatory drugs.