Meta-Analysis of PENG+LFCN versus FICB on ERAS-Related Outcomes: Postoperative Pain, Motor Function and Recovery in Hip Surgery

Objective To compare pericapsular nerve group block combined with lateral femoral cutaneous nerve block (PENG+LFCN) with fascia iliaca compartment block (FICB) for postoperative analgesia and functional recovery after hip surgery within Enhanced Recovery After Surgery (ERAS) pathways.Methods PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and CQVIP were searched through January 2026. Comparative studies of PENG+LFCN versus FICB in hip surgery were included. Data were pooled using a random-effects model, with assessment of bias, heterogeneity, and publication bias.Results Sixteen studies were included. The PENG+LFCN group had significantly lower resting VAS (MD = −0.54; p < 0.00001) and dynamic VAS (MD = −0.98; p < 0.00001) scores. It also showed a lower incidence of postoperative muscle weakness (OR = 0.10; p = 0.0001), better preservation of quadriceps muscle strength, shorter time to first ambulation (MD = −9.22 h; p < 0.0001), and reduced length of stay (MD = −0.75 days; p < 0.00001). Additionally, morphine consumption (MD = −24.22 mg; p = 0.001) and PCA pump activations (MD = −2.46; p < 0.00001) were lower in the PENG+LFCN group.Conclusion PENG+LFCN may be a more favorable regional analgesic strategy than FICB for hip surgery within ERAS pathways.Protocol registration This systematic review and meta-analysis was registered at PROSPERO https://www.crd.york.ac.uk/PROSPERO/view/CRD420261295309