The effect of adding lateral femoral cutaneous nerve block to pericapsular nerve group (PENG) block in hip surgery on postoperative opioid consumption

Aim: To compare the effect of lateral femoral cutaneous nerve (LFCN) block added to Pericapsular Nerve Group (PENG) block on pain scores and opioid consumption in hip fracture operations under spinal anesthesia. Materials and Method: Sixty patients over 18 years of age in the ASA I-III risk group undergoing hip fracture surgery under spinal anesthesia were included. Patients were divided into Group PENG (n=20), Group PENG+LFCN (n=20) and Group CONTROL (n=20) by computer assisted randomization. Spinal anesthesia was performed 20 minutes after the preoperative block was induced. Pain scores during spinal anesthesia position, intraoperative hemodynamic data, time to first analgesic requirement, postoperative opioid consumption and pain scores, time to first mobilization, intraoperative and postoperative complications, length of hospital stay, and patient and surgeon satisfaction were recorded. Results: Postoperative opioid consumption was lower in the PENG and PENG+LFCN groups compared to the CONTROL group (p<0.001), whereas there was no difference between the PENG and PENG+LFCN groups (p=1). Pain scores were lower in the PENG+LFCN group than in the CONTROL group during spinal anesthesia positioning and at all postoperative time points (p<0.05). Patient and surgeon satisfaction was higher in the block groups compared to the CONTROL group. The duration of the first postoperative analgesic requirement was shorter in the CONTROL group than in the PENG and PENG+LFCN groups (p<0.001). Conclusions: We demonstrated that the addition of LFCN block to PENG block in patients undergoing hip fracture surgery under spinal anesthesia did not contribute to postoperative opioid consumption. We consider that preoperative PENG block has an important role both during positioning for spinal anesthesia and in postoperative analgesia management. Keywords: Pericapsular Nerve Group Block, Lateral Femoral Cutaneous Nerve Block, Patient Controlled Analgesia, Opioid Consumption