REVIEW   Free access

Minerva Anestesiologica 2021 April;87(4):458-66

DOI: 10.23736/S0375-9393.20.14798-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Pericapsular nerve group block: an overview

Romualdo DEL BUONO ¹, Eleonora PADUA ¹, Giuseppe PASCARELLA ² ✉, Fabio COSTA ², Andrea TOGNÙ ³, Gaetano TERRANOVA ⁴, Federico GRECO ⁵, Mario FAJARDO PEREZ ⁶, Enrico BARBARA ¹

¹ Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, Humanitas Mater Domini Hospital, Castellanza, Varese, Italy; ² Unit of Anesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University, Rome, Italy; ³ Department of Anesthesia and Postoperative Intensive Care, Rizzoli Orthopedic Institute, Bologna, Italy; ⁴ Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy; ⁵ Unit of Diagnostics for Corporate Territorial Images, Cittadella della Salute, ASL Lecce, Lecce, Italy; ⁶ Department of Anesthesia, Department of Chronic Pain, Hospital Móstoles, Madrid, Spain

INTRODUCTION: The PENG block is a recently described ultrasound-guided technique for the blockade of the sensory nerve branches to the anterior hip joint capsule. It was described as an analgesic block for the acute pain management after hip fracture, while subsequent studies expanded the original indication. The aim of this narrative review was to summarize the existing knowledge about the PENG block from the anatomical bases and to provide an up-to-date description of the technique, applications and effects.
EVIDENCE ACQUISITION: We reviewed the following medical literature databases for publications on PENG block: PubMed, Google Scholar, EMBASE, and Web of science until August 31st, 2020. Data regarding anatomy, indications, drugs and technique were also collected, reported and discussed.
EVIDENCE SYNTHESIS: From our search result we selected 57 relevant publications. Among them, 36 were case reports or case series and 12 publication were letters or correspondence; no RCT was identified. The main indication is the hip-related analgesia. The most commonly injected drug is a 20ml long-acting local anesthetic. There are some cases of femoral and obturator nerve block, but no major complication such as hematoma/bleeding or needle-related organ injury has been reported yet.
CONCLUSIONS: The PENG block is a promising technique. Randomized controlled trials of high methodological quality are required to further elaborate the role of this block.

KEY WORDS: Anesthesia; Analgesia; Hip fractures