Accuracy of Hip Pericapsular Nerve Block (PENG) without Ultrasound Aid in Patients with Hip Pain

Abstract

Objective

To describe and evaluate the accuracy of the pericapsular nerve group (PENG) block technique with no ultrasound guidance.

Method

Series of 40 infiltrations in patients with hip pain undergoing outpatient follow-up in the hip surgery group or admitted to the emergency room from a hospital in São Paulo, SP, Brazil. The hip PENG technique was guided by palpable anatomical pelvic structures, with no ultrasound orientation for needle positioning, using the equipment only to check the correct location after an unguided puncture.

Results

In the 40 hips infiltrated from 35 patients with a mean age of 59.2 years, the success rate was 85%. Among the mispositioned cases, 71.4% occurred in the first 13 applications and 28.6% in the subsequent 27 applications. In all patients, the neurovascular bundle was in the medial third of the pen-made demarcation. Even in cases with a failed needle location, the distance from the neurovascular bundle was safe. A single adverse effect occurred, with spontaneous improvement of the femoral nerve apraxia within two days.

Conclusion

Unguided PENG block is a viable technique for a physician knowledgeable about its application in services with no ultrasound availability.

Keywords
analgesia; anesthesia; nerve block; hip fractures; pain management