Comparative Study Between Pericapsular Nerve Group Block (PENG) And Pericapsular Nerve Group (PENG) Block Combined With Lateral Femoral Cutaneous Nerve (LFCN) Block for Positioning Analgesia Prior to Spinal Anesthesia in Hip Fracture Patients

Comparative Study Between Pericapsular Nerve Group Block (PENG) And Pericapsular Nerve Group (PENG) Block Combined With Lateral Femoral Cutaneous Nerve (LFCN) Block for Positioning Analgesia Prior to Spinal Anesthesia in Hip Fracture Patients

To evaluate and compare the effectiveness of the Pericapsular Nerve Group (PENG) block alone versus the PENG block combined with the Lateral Femoral Cutaneous Nerve (LFCN) block in providing adequate analgesia for patient positioning during spinal anesthesia in individuals undergoing surgery for hip fracture.

Hip fractures are common among adult patients and often necessitate urgent surgical intervention. Positioning these patients for spinal anesthesia in sitting position is often difficult due to intense pain from the fracture. PENG block is a novel regional technique that targets the articular branches of the femoral nerve, obturator nerve, and accessory obturator nerve, providing excellent anterior hip analgesia sparing the motor function. It is performed under ultrasound guidance and has shown promising results in perioperative pain management. By combining LFCN block with the PENG block, more complete sensory blockade may be achieved. The effectiveness of this combination has not yet been adequately studied, particularly regarding positioning for spinal anesthesia. Therefore, this trial aims to compare the analgesic efficacy of PENG block alone versus PENG +LFCN block in this specific context.

Inclusion Criteria:

• Age 18-70 years.
• ASA I-II.
• Confirmed primary unilateral hip fracture.
• Scheduled for surgery under spinal anesthesia.
• Patients able to provide informed consent.

Exclusion Criteria:

• Allergy to local anesthetics.
• Coagulopathy or on anticoagulant therapy.
• Infection at injection site.
• Pre-existing neurological deficits in the lower limbs.
• Multiple trauma or polytrauma (If other injuries might interfere with positioning or pain scoring).
• Previous surgery on the ipsilateral hip affecting anatomy or nerve distribution.