{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:24:10Z","timestamp":1792844650389,"version":"4.5.0"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While the pericapsular nerve group (PENG) block has become increasingly popular for managing pain after hip surgery, its efficacy remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched Pubmed, Web of Science, Embase, and the Cochrane Library for randomized controlled trials to assess current evidence about the efficacy of the PENG block. Patients who received PENG block were compared to those who received sham\/no block in terms of opioid consumption and pain within 24h after surgery, time to first opioid requirement, functional recovery, risk of nausea and vomiting, and patient dissatisfaction. The quality of evidence was assessed using the \"Grading of Recommendations Assessment, Development and Evaluation\" (GRADE) system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We meta-analyzed six trials involving 416 patients who received preoperative PENG block and 415 who received sham\/no block. Patients did not receive any other type of multimodal analgesia. Within 24 h after hip surgery, PENG block significantly reduced postoperative opioid consumption (MD = -12.03, 95% CI: -21.47 to -2.59,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sup>\n                      = 97%), particularly in subpopulations undergoing hip replacement, hip fracture, or who had spinal anesthesia, and it significantly decreased dynamic pain scores, but not static scores, without increasing risk of nausea or vomiting or patient dissatisfaction. Individual studies suggested that the PENG block can prolong the time to the first opioid requirement and can improve functional recovery. Most meta-analyses provided evidence of moderate quality according to the GRADE system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The available evidence indicates that preoperative PENG block can significantly decrease opioid consumption and pain early after hip surgery, and it may also promote early functional rehabilitation. However, the limited number of included studies and sample size make it difficult to draw firm conclusions. The decision on whether to apply the PENG block should take into account the patient\u2019s age and the type of surgery and anesthesia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0310008","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T13:25:07Z","timestamp":1731072307000},"page":"e0310008","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pericapsular nerve group block reduces opioid use and pain after hip surgery: A systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1371","volume":"19","author":[{"given":"Xianghong","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahao","family":"Chenyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangjun","family":"Lao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfeng","family":"Sheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuliang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5217-6067","authenticated-orcid":true,"given":"Yuliang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,8]]},"reference":[{"issue":"6","key":"pone.0310008.ref001","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/BF01623184","article-title":"Hip fractures in the elderly: a world-wide projection","volume":"2","author":"C Cooper","year":"1992","journal-title":"Osteoporos Int"},{"issue":"1","key":"pone.0310008.ref002","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12891-023-06166-7","article-title":"Construction and validation of a risk prediction model for delayed discharge in elderly patients with hip fracture","volume":"24","author":"H Cao","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"issue":"8","key":"pone.0310008.ref003","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1002\/jbmr.4821","article-title":"Global Epidemiology of Hip Fractures: Secular Trends in Incidence Rate, Post-Fracture Treatment, and All-Cause Mortality","volume":"38","author":"CW Sing","year":"2023","journal-title":"J Bone Miner Res"},{"issue":"3","key":"pone.0310008.ref004","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/joim.12586","article-title":"Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project","volume":"281","author":"M Katsoulis","year":"2017","journal-title":"J Intern Med"},{"issue":"8","key":"pone.0310008.ref005","doi-asserted-by":"crossref","first-page":"e386","DOI":"10.1016\/S2666-7568(23)00086-7","article-title":"Organisational factors associated with hospital costs and patient mortality in the 365 days following hip fracture in England and Wales (REDUCE): a record-linkage cohort study","volume":"4","author":"P Baji","year":"2023","journal-title":"Lancet Healthy Longev"},{"issue":"11","key":"pone.0310008.ref006","first-page":"CD001159","article-title":"Peripheral nerve blocks for hip fractures in adults","volume":"11","author":"J Guay","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"20","key":"pone.0310008.ref007","first-page":"e1291","article-title":"AAOS Clinical Practice Guideline Summary: Management of Hip Fractures in Older Adults","volume":"30","author":"MI O\u2019Connor","year":"2022","journal-title":"J Am Acad Orthop Surg"},{"key":"pone.0310008.ref008","first-page":"100822","article-title":"Postoperative pain-related outcomes and perioperative pain management in China: a population-based study","volume":"39","author":"Y Liu","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"issue":"2","key":"pone.0310008.ref009","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1093\/ageing\/afaa204","article-title":"Discharge after hip fracture surgery by mobilisation timing: secondary analysis of the UK National Hip Fracture Database","volume":"50","author":"KJ Sheehan","year":"2021","journal-title":"Age Ageing"},{"issue":"5","key":"pone.0310008.ref010","doi-asserted-by":"crossref","first-page":"e239","DOI":"10.1016\/S2468-2667(17)30046-4","article-title":"Burden of hip fracture using disability-adjusted life-years: a pooled analysis of prospective cohorts in the CHANCES consortium","volume":"2","author":"N Papadimitriou","year":"2017","journal-title":"Lancet Public Health"},{"issue":"6","key":"pone.0310008.ref011","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.jos.2018.06.011","article-title":"Opioid administration via epidural catheter is a risk factor for postoperative nausea and vomiting in total hip arthroplasty: A retrospective study","volume":"23","author":"T Ukai","year":"2018","journal-title":"J Orthop Sci"},{"key":"pone.0310008.ref012","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jclinane.2018.12.013","article-title":"Respiratory depression after intraoperative opioid-containing periarticular multimodal drug injection for total hip and total knee arthroplasty","volume":"54","author":"K Yoshida","year":"2019","journal-title":"J Clin Anesth"},{"key":"pone.0310008.ref013","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jclinane.2019.03.021","article-title":"Postoperative cognitive dysfunction is rare after fast-track hip- and knee arthroplasty\u2014But potentially related to opioid use","volume":"57","author":"HN Awada","year":"2019","journal-title":"J Clin Anesth"},{"issue":"4","key":"pone.0310008.ref014","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1503\/cjs.011419","article-title":"Surgeons as advocates for opioid control","volume":"62","author":"CG Ball","year":"2019","journal-title":"Can J Surg"},{"issue":"7","key":"pone.0310008.ref015","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1001\/jamasurg.2017.0898","article-title":"Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques: A Review","volume":"152","author":"EC Wick","year":"2017","journal-title":"JAMA Surg"},{"issue":"8","key":"pone.0310008.ref016","first-page":"859","article-title":"Pericapsular Nerve Group (PENG) Block for Hip Fracture","volume":"43","author":"L Gir\u00f3n-Arango","year":"2018","journal-title":"Reg Anesth Pain Med"},{"issue":"15","key":"pone.0310008.ref017","doi-asserted-by":"crossref","first-page":"4931","DOI":"10.3390\/jcm12154931","article-title":"Pain Management and Functional Recovery after Pericapsular Nerve Group (PENG) Block for Total Hip Arthroplasty: A Prospective, Randomized, Double-Blinded Clinical Trial","volume":"12","author":"M Domagalska","year":"2023","journal-title":"J Clin Med"},{"issue":"11","key":"pone.0310008.ref018","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1111\/anae.15536","article-title":"Impact 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":"G Pascarella","year":"2021","journal-title":"Anaesthesia"},{"issue":"6","key":"pone.0310008.ref019","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.bja.2023.02.017","article-title":"Quality of recovery after pericapsular nerve group (PENG) block for primary total hip arthroplasty under spinal anaesthesia: a randomised controlled observer-blinded trial","volume":"130","author":"P Kukreja","year":"2023","journal-title":"Br J Anaesth"},{"key":"pone.0310008.ref020","article-title":"Pericapsular nerve group (PENG) block for hip arthroscopy: a randomized, double-blinded, placebo-controlled trial","author":"PE Amato","year":"2022","journal-title":"Reg Anesth Pain Med"},{"issue":"1","key":"pone.0310008.ref021","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s00540-022-03129-5","article-title":"Does pericapsular nerve group block have limited analgesia at the initial post-operative period? Systematic review and meta-analysis","volume":"37","author":"A Farag","year":"2023","journal-title":"J Anesth"},{"issue":"2","key":"pone.0310008.ref022","doi-asserted-by":"crossref","first-page":"63","DOI":"10.5371\/hp.2023.35.2.63","article-title":"Efficacy of Pericapsular Nerve Group Block for Pain Reduction and Opioid Consumption after Total Hip Arthroplasty: A Meta-Analysis of Randomized Controlled Trials","volume":"35","author":"E Kim","year":"2023","journal-title":"Hip Pelvis"},{"issue":"9","key":"pone.0310008.ref023","first-page":"e28872","article-title":"The Use of Pericapsular Nerve Group (PENG) Block in Hip Surgeries Is Associated With a Reduction in Opioid Consumption, Less Motor Block, and Better Patient Satisfaction: A Meta-Analysis","volume":"14","author":"AU Huda","year":"2022","journal-title":"Cureus"},{"issue":"6","key":"pone.0310008.ref024","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1002\/pds.3945","article-title":"A synthesis of oral morphine equivalents (OME) for opioid utilisation studies","volume":"25","author":"S Nielsen","year":"2016","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"7650","key":"pone.0310008.ref025","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"GH Guyatt","year":"2008","journal-title":"BMJ"},{"key":"pone.0310008.ref026","doi-asserted-by":"crossref","DOI":"10.1002\/9781119536604","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"JPT Higgins","year":"2019","edition":"2"},{"key":"pone.0310008.ref027","doi-asserted-by":"crossref","first-page":"6022380","DOI":"10.1155\/2022\/6022380","article-title":"Reduced Opioid Consumption with Pericapsular Nerve Group Block for Hip Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial","volume":"2022","author":"CJ Chung","year":"2022","journal-title":"Pain Res Manag"},{"issue":"2","key":"pone.0310008.ref028","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.arthro.2023.06.016","article-title":"Pericapsular Nerve Group Block Leads to Small but Consistent Reductions in Pain Between 18 and 24 Hours\u2019 Postoperatively in Hip Arthroscopy for Femoroacetabular Impingement Surgery: A Prospective, Randomized Controlled Clinical Trial","volume":"40","author":"B Eppel","year":"2024","journal-title":"Arthroscopy"},{"issue":"11","key":"pone.0310008.ref029","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1136\/rapm-2022-104117","article-title":"Pericapsular nerve group (PENG) block for early pain management of elderly patients with hip fracture: a single-center double-blind randomized controlled trial","volume":"48","author":"X Lin","year":"2023","journal-title":"Reg Anesth Pain Med"},{"issue":"1","key":"pone.0310008.ref030","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.bja.2021.02.036","article-title":"Procedure-specific acute pain trajectory after elective total hip arthroplasty: systematic review and data synthesis","volume":"127","author":"P Panzenbeck","year":"2021","journal-title":"Br J Anaesth"},{"issue":"2","key":"pone.0310008.ref031","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1093\/bja\/aev413","article-title":"Measuring quality of recovery-15 after day case surgery","volume":"116","author":"M Chazapis","year":"2016","journal-title":"Br J Anaesth"},{"issue":"1","key":"pone.0310008.ref032","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1080\/11101849.2023.2180540","article-title":"Comparison between pericapsular nerve group block and fascia iliaca compartment block for perioperative pain control in hip surgeries: A meta-analysis from randomized controlled trials","volume":"39","author":"SR Amin","year":"2023","journal-title":"Egypt J Anaesth"},{"issue":"1","key":"pone.0310008.ref033","first-page":"56","article-title":"Comparison of pericapsular nerve group block and fascia iliaca compartment block for analgesia following hip fracture surgery: a meta-analysis","volume":"43","author":"C Li","year":"2023","journal-title":"Chinese J Anesth"},{"issue":"2","key":"pone.0310008.ref034","doi-asserted-by":"crossref","first-page":"e14637","DOI":"10.1111\/iwj.14637","article-title":"Comparative effectiveness of pericapsular nerve group block versus fascia iliac compartment block on postoperative wound pain management in patients undergoing hip fracture surgery: A systematic review and meta-analysis","volume":"21","author":"Z Mou","year":"2024","journal-title":"Int Wound J"},{"issue":"11","key":"pone.0310008.ref035","doi-asserted-by":"crossref","first-page":"962","DOI":"10.4103\/ija.ija_672_23","article-title":"Comparison of analgesic effects of pericapsular nerve group block and fascia iliaca compartment block during hip arthroplasty: A systematic review and meta-analysis of randomised controlled trials","volume":"67","author":"J Prakash","year":"2023","journal-title":"Indian J Anaesth"},{"issue":"1","key":"pone.0310008.ref036","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1186\/s13018-024-04707-x","article-title":"The efficacy of pericapsular nerve group block for reducing pain and opioid consumption after total hip arthroplasty: a systematic review and meta-analysis","volume":"19","author":"C She","year":"2024","journal-title":"J Orthop Surg Res"},{"issue":"1","key":"pone.0310008.ref037","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/17453674.2019.1683790","article-title":"Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS\u00ae) Society recommendations","volume":"91","author":"TW Wainwright","year":"2020","journal-title":"Acta Orthop"},{"issue":"7","key":"pone.0310008.ref038","doi-asserted-by":"crossref","first-page":"952","DOI":"10.7326\/M22-0320","article-title":"Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery: A Randomized Clinical Trial","volume":"175","author":"MD Neuman","year":"2022","journal-title":"Ann Intern Med"},{"issue":"3","key":"pone.0310008.ref039","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1136\/rapm-2021-103228","article-title":"Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebo-controlled trial","volume":"47","author":"J Zheng","year":"2022","journal-title":"Reg Anesth Pain Med"},{"issue":"6","key":"pone.0310008.ref040","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1016\/j.arth.2022.12.023","article-title":"Efficacy of Ultrasound-Guided Pericapsular Nerve Group (PENG) Block Combined With Local Infiltration Analgesia on Postoperative Pain After Total Hip Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial","volume":"38","author":"J Hu","year":"2023","journal-title":"J Arthroplasty"},{"issue":"10","key":"pone.0310008.ref041","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1136\/rapm-2023-104332","article-title":"Randomized clinical trial comparing pericapsular nerve group (PENG) block and periarticular local anesthetic infiltration for total hip arthroplasty","volume":"48","author":"D Bravo","year":"2023","journal-title":"Reg Anesth Pain Med"},{"key":"pone.0310008.ref042","doi-asserted-by":"crossref","first-page":"116","DOI":"10.3389\/fnagi.2020.00116","article-title":"Age-Related Changes in Pain Perception Are Associated With Altered Functional Connectivity During Resting State","volume":"12","author":"AM Gonz\u00e1lez-Rold\u00e1n","year":"2020","journal-title":"Front Aging Neurosci"},{"issue":"3","key":"pone.0310008.ref043","doi-asserted-by":"crossref","first-page":"317","DOI":"10.2217\/pmt-2018-0030","article-title":"Racial and ethnic differences in the experience and treatment of noncancer pain","volume":"9","author":"SM Meints","year":"2019","journal-title":"Pain Manag"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T13:25:20Z","timestamp":1731072320000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310008"}},"subtitle":[],"editor":[{"given":"Robert Jeenchen","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,8]]},"references-count":43,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0310008","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,8]]}}}