Publication date: Jul 15, 2024

The pericapsular nerve group (PENG) block is a newly developed regional anesthesia technique designed to manage post-operative hip pain following a fracture or surgery while also maintaining quadriceps strength and mobility. The goal of our study was to compare post-operative pain scores and opioid usage during the post-operative period prior to discharge following total hip arthroplasty (THA) using the posterior approach between patients who received a PENG block and those who did not. We conducted a retrospective study on patients undergoing elective, posterior approach THA at a single tertiary care academic center. The two groups included a study group (THA with PENG block in 2021; n = 66) and a control group (THA prior to PENG block implementation in 2019; n = 70). There were no significant differences in pain scores during post-operative minutes 0 to 59 (study group 6. 8; control group 6. 6; P = 0. 81) or during post-operative minutes 60 to 119 (study group 6. 2; control group 5. 6; P = 0. 40). There were no significant differences in total post-operative in-hospital morphine milliequivalent (MME) opioid consumption (study group 55. 8 MMEs; control group 75. 0 MMEs; P = 0. 14). The study group was found to have a shorter length of stay (LOS) (study group 17. 0 hours; control group 32. 6 hours; P < 0. 0001) and faster mobilization (study group 3. 0 hours; control group 4. 9 hours; P < 0. 0001) than the control group. Our results show that use of the PENG block did not result in lower post-operative pain scores or opioid consumption after THA using the posterior surgical approach. The study group had a shorter LOS and time to mobilization than the control group, though this was likely due to standard hospital procedure shifting to same day discharge for THA between 2019 and 2021 due to COVID-19.

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