{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T04:33:05Z","timestamp":1778819585343,"version":"3.51.4"},"reference-count":31,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2022,8,17]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The novel pericapsular nerve group (PENG) block has recently been reported to provide effective motor-sparing local anesthetic-based analgesia to the hip joint. We aimed to evaluate the analgesic efficacy and safety of a preoperative PENG block among patients undergoing ambulatory hip arthroscopic surgery where systemic analgesia is the gold standard.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a single-center, retrospective pragmatic exploratory cohort study of consecutive outpatient hip arthroscopic surgery cases from January 2017 to March 2019. We identified 164\u2009cases in which patients received general anesthesia with or without a preoperative PENG block. The primary analgesic outcome measures were time to first postoperative analgesic request, intraoperative and postoperative opioid consumption (intravenous morphine equivalent), and postoperative pain severity (visual analog scale 10\u2009cm scale ranging from 0=no\u2009pain to 10=severe\u2009pain) in hospital. Secondary outcomes included duration of stay in the postanesthesia care unit, opioid-related side effects, time to discharge readiness, and block-related complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventy-five cases received a preoperative PENG block and 89 cases received systemic analgesia alone. The addition of a PENG block reduced intraoperative (6.6\u2009mg vs 7.5\u2009mg, difference: 0.9\u2009mg; 95%\u2009CI 0.2 to 1.7; p=0.01) and postoperative (10.7\u2009mg vs 13.9\u2009mg, difference: 3.2\u2009mg; 95%\u2009CI 0.9 to 5.5; p=0.01) intravenous morphine consumption, as well as the mean (3.5 vs 4.2, difference: 0.7; 95%\u2009CI 0.1 to 1.3; p=0.03) and highest (5.5 vs 6.5, difference: 1.0; 95%\u2009CI 0.2 to 1.7; p=0.02) postoperative pain severity scores in hospital. The PENG block did not prolong the time to first analgesic request (15.8\u2009min vs 12.3\u2009min, difference: 3.5\u2009min; 95%\u2009CI \u22129.0 to 2.0; p=0.23). Fewer patients in the PENG group experienced postoperative nausea and vomiting compared with systemic analgesia alone (36% vs 52%, OR 1.9; 95%\u2009CI 1.0 to 3.6; p=0.02), while the PENG block expedited discharge readiness (165.0\u2009min vs 202.8\u2009min, difference: 37.8\u2009min; 95%\u2009CI 2.9 to 72.3; p=0.04). No block-related complications were noted in any patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Based on our retrospective dataset, this pragmatic exploratory cohort study suggests that a preoperative PENG block is associated with questionable improvements in postoperative in-hospital analgesic outcomes which may or may not prove to be clinically relevant when compared with systemic analgesia alone for patients undergoing hip arthroscopic surgery. This small signal should be investigated in a prospective randomized trial.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2022-103743","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T12:50:19Z","timestamp":1661431819000},"page":"733-737","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["The analgesic benefit of Pericapsular Nerve Group (PENG) block in hip arthroscopic surgery: a retrospective pragmatic analysis at an academic health center"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7906-2276","authenticated-orcid":false,"given":"Vanisha","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faraj","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Women's College Research Institute, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Whelan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Sport Medicine, Women's College Hospital, Toronto, Ontario, Canada"},{"name":"Department of Orthopaedic Sport Medicine, St Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shikha","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martino","family":"Gabra","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7708-8843","authenticated-orcid":false,"given":"Richard","family":"Brull","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada"},{"name":"Department of Anesthesiology and Pain Medicine, Women's College Hospital, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"2025101111072511000_47.12.733.1","doi-asserted-by":"crossref","first-page":"3288","DOI":"10.1177\/0363546517734518","article-title":"Pain 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of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial","volume":"76","author":"Pascarella","year":"2021","journal-title":"Anaesthesia"},{"key":"2025101111072511000_47.12.733.23","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2021-103228"},{"key":"2025101111072511000_47.12.733.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2007.08.012"},{"key":"2025101111072511000_47.12.733.25","doi-asserted-by":"publisher","DOI":"10.1016\/0952-8180(95)00130-A"},{"key":"2025101111072511000_47.12.733.26","unstructured":"Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain\u00a9 2010 National Opioid Use Guideline Group (NOUGG) - Part B: Recommendations for Practice, Version 5.6 April 30 2010. Available: http:\/\/nationalpaincentre.mcmaster.ca\/opioid\/"},{"key":"2025101111072511000_47.12.733.27","article-title":"ESRA19-0288\u2005Hip arthroscopy \u2013 is the pericapsular nerve group block approach plus a subpectineal injection the key to successful analgesia? Two case reports","volume":"44","author":"Silva","year":"2019","journal-title":"Reg Anesth Pain Med"},{"key":"2025101111072511000_47.12.733.28","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jclinane.2019.04.037","article-title":"Pericapsular Nerve Group (PENG) block for perioperative pain control in hip arthroscopy","volume":"59","author":"Orozco","year":"2020","journal-title":"J Clin Anesth"},{"key":"2025101111072511000_47.12.733.29","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/j.arthro.2019.11.118","article-title":"Should preoperative fascia Iliaca block be used for hip arthroscopic Labral repair and femoroacetabular impingement treatment? 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