PENG, fascia-iliaca compartment block or femoral nerve block for pain management of patients with hip fractures.

作者：J. Dolstra, H. Vlieg, S. Haak, E. ter Avest, E. Boerma, H. Lameijer · 发表于：American Journal of Emergency Medicine · 年份：2025 · DOI：10.1016/j.ajem.2025.06.009 · 被引用次数：13 · 研究领域：Medicine

BACKGROUND Currently three types of regional nerve blocks are commonly administered to provide analgesia to patients with hip fractures; the Fascia-Iliaca Compartment Block (FICB), Femoral Nerve Block (FNB) and Pericapsular Nerve Group Block (PENG). It is unclear which of these provides the best analgesia and the lowest number of complications. AIM This systematic review aims to evaluate the literature concerning the efficacy and safety of pre-operatively placed PENG block compared to FICB and FNB for hip fractures. METHODS The PRISMA statement guidelines were used and a systematic search of MEDLINE (via Ovid), Embase, Web of Science and Google Scholar was performed until April 8th, 2024. RESULTS Out of 118 identified studies, 17 (14 RCTs, 3 observational) met the inclusion criteria, of which 5 exhibited a low risk of bias. Pain scores were significantly lower with the PENG block compared to FICB/FNB in 12 of 17 studies, while 5 reported no difference. Opioid use was lower in 4 of 11 studies favoring PENG, while the other 7 showed no differences with FICB/FNB. Patient satisfaction was found to be higher in PENG in 5 studies, while 2 other reported no difference. Ease of spinal positioning was better with PENG in 4 studies, with 3 reporting no difference. Adverse events showed no significant differences between blocks. None of the studies found FNB or FICB to be favorable on any of these outcomes. CONCLUSIONS PENG block may be a promising technique to provide analgesia...