Work

Erector spinae plane block (ESPB) vs. pericapsular nerve group (PENG) block in total hip arthroplasty in elderly patients: a randomized, double-blinded, controlled trial

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Introduction This study evaluated the efficacy of ultrasound-guided erector spinae plane block (ESPB) and pericapsular nerve group (PENG) block under spinal anesthesia for postoperative analgesia in elderly patients undergoing total hip arthroplasty. Material and methods In this randomized, controlled, double-blind study, 90 elderly patients (aged 67-89 years, ASA II and III), scheduled for total hip arthroplasty under spinal anesthesia were randomly allocated to three groups: PENG block (n = 30), ESPB (n = 30), and Control group (n = 30). Ultrasound-guided blocks were administered using 20 mL of 0.2% ropivacaine. The primary outcome was total opioid consumption over 48 hours. Secondary outcomes included pain scores, time to first rescue opioid analgesia, quadriceps muscle strength, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). Results Opioid consumption within 48 hours was significantly lower in both the PENG (3.5 ± 4.0) and ESPB (3.4 ± 3.8) groups compared to the Control group (16.07 ± 3.8 ), with P < 0.001, and no significant difference between PENG and ESPB groups (P = 1.0). Time to first rescue analgesia was longer in the PENG (12.3 ± 3.2) and ESPB (11.2 ± 2.9) groups relative to the Control group (4.2 ± 1.1), P < 0.001. Pain scores remained consistently lower in both intervention groups at all time points compared to the Control group. Quadriceps strength was lower in the PENG group at 6 hours postoperatively compared to ESPB. NLR and PLR values were lower in both block groups than in the Control group. Conclusions Ultrasound-guided PENG and ESPB are effective for postoperative analgesia in elderly patients undergoing total hip arthroplasty, significantly reducing opioid requirements and enhancing recovery quality.

Source: Anaesthesiology Intensive Therapy

DOI: 10.5114/ait/203170

Authors: Tomasz Reysner, Grzegorz Kowalski, Małgorzata Reysner, Lukasz Lapaj, Przemyslaw Daroszewski, Katarzyna Wieczorowska-Tobis

Institution: Poznan University of Medical Sciences

Language: English

Topic: Anesthesia and Pain Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4410402152