Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Randomization Process and Blinding Procedures
2.2. Anesthetic Protocol
2.3. Outcome Variables
2.4. Sample Size Estimation and Statistical Analysis
3. Results
3.1. Motor Function
3.2. Hip Flexion
3.3. Time to Ambulation
3.4. Pain Outcomes
3.5. Opioid Consumption and PONV
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
THA | Total hip arthroplasty |
PENG | Pericapsular Nerve Group |
LFCN | Lateral femoral cutaneous nerve |
FICB | Fascia Iliaca Compartment Block |
RCT | Randomized clinical trial |
PROSPECT | Procedure-Specific Postoperative Pain Management |
ICAROS | International Consensus on Anaesthesia-Related Outcomes after Surgery group |
INR | International normalized ratio |
aPTT | Activated partial thromboplastin time |
ASA | American Society of Anesthesiologists |
AIIS | Anterior inferior iliac spine |
IPE | Iliopubic eminence |
FFFT | Fat-filled flat tunnel |
SaM | Sartorius muscle |
TFLM | Tensor fascia latae muscle |
RF | Rectus Femoris Muscle. |
MRC | Medical Research Council Scale for Muscle Strength |
NRS | Numerical Rating Scale |
ERAS | Early Recovery After Surgery |
BMI | Body Mass Index |
PRN | Pro Re Nata |
MME | Morphine Milligram Equivalent |
PONV | Postoperative nausea and vomiting |
MCID | Minimal clinically important difference |
VAS | Visual analog scale |
DAA | Direct anterior approach |
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Variable | FICB (n = 29) | PENG + LFCN (n = 29) | Standardized Difference | p |
---|---|---|---|---|
Age (years) | 71 ± 9 | 71 ± 10 | 0.0319 | 0.9053 |
Body weight (kg) | 78.4 ± 16.6 | 79.8 ± 14.3 | −0.0868 | 0.7423 |
Height (cm) | 164.9 ± 8.9 | 169.1 ± 7.3 | −0.5028 | 0.0606 |
BMI (kg/m2) | 28.8 ± 5.7 | 27.8 ± 3.9 | 0.1196 | 0.4065 |
Male sex | 14 (48.2%) | 19 (65.5%) | −0.1474 | 0.1850 |
ASA status | 2 [2; 2] | 2 [2; 2] | 0.0001 | 0.8283 |
Chronic pain medication | 2 (6.9%) | 3 (10.3%) | −0.1209 | 0.6402 |
Diabetes mellitus | 5 (17.2%) | 6 (20.7%) | −0.0865 | 0.7381 |
Italian nationality | 29 (100%) | 29 (100%) | 0.0001 | >0.9999 |
Variable | FICB (n = 29) | PENG + LFCN (n = 29) | P (Group) | P (Time) | P (Interaction) |
---|---|---|---|---|---|
MRC scale | <0.0001 | 0.0304 | 0.0777 | ||
6 h | 3 [3; 4] | 4 [4; 4] | |||
24 h | 4 [3; 4] | 4 [4; 4] | |||
48 h | 4 [3; 4] | 4 [4; 5] | |||
Degree of hip flexion | <0.0001 | <0.0001 | 0.7405 | ||
6 h | 30 [25; 43] | 45 [37; 60] | |||
24 h | 47 [36; 50] | 59 [49; 66] | |||
48 h | 50 [40; 55] | 62 [55; 70] | |||
Static NRS | <0.0001 | 0.4825 | 0.3585 | ||
6 h | 2 [0; 3] | 0 [0; 1] | |||
24 h | 1 [0; 3] | 0 [0; 2] | |||
48 h | 1 [0; 3] | 0 [0; 1] | |||
Dynamic NRS | 0.0001 | 0.0381 | 0.1029 | ||
6 h | 3 [2; 5] | 1 [0; 2] | |||
24 h | 3 [2; 4] | 2 [2; 4] | |||
48 h | 3 [1; 3] | 2 [1; 2] |
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Vetrone, F.; Marelli, S.; Galimberti, A.; Umbrello, M.; Gotti, M.; Pezzi, A.; Girombelli, A. Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial. J. Pers. Med. 2025, 15, 230. https://doi.org/10.3390/jpm15060230
Vetrone F, Marelli S, Galimberti A, Umbrello M, Gotti M, Pezzi A, Girombelli A. Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial. Journal of Personalized Medicine. 2025; 15(6):230. https://doi.org/10.3390/jpm15060230
Chicago/Turabian StyleVetrone, Francesco, Stefano Marelli, Andrea Galimberti, Michele Umbrello, Miriam Gotti, Angelo Pezzi, and Alessandro Girombelli. 2025. "Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial" Journal of Personalized Medicine 15, no. 6: 230. https://doi.org/10.3390/jpm15060230
APA StyleVetrone, F., Marelli, S., Galimberti, A., Umbrello, M., Gotti, M., Pezzi, A., & Girombelli, A. (2025). Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial. Journal of Personalized Medicine, 15(6), 230. https://doi.org/10.3390/jpm15060230