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Minerva Anestesiologica 2021 Jan 12

DOI: 10.23736/S0375-9393.20.14798-9


language: English

Pericapsular Nerve Group (PENG) block: an overview

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

1 Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, Humanitas Mater Domini Hospital, Castellanza, Varese, Italy; 2 Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy; 3 Department of Anaesthesia and Postoperative Intensive Care, Rizzoli Orthopaedic Institute, Bologna, Italy; 4 Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milano, Italy; 5 U.O.C. Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Lecce, Italy; 6 Department of Anesthesia and Chronic Pain Department Hospital Móstoles, Madrid, Spain


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 is 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. 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. 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 longacting 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. 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: Regional anaesthesia; Analgesia; Hip fracture; PENG; Hip surgery

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