Efficacy of Ultrasound-guided Pericapsular Nerve Group Block versus Suprainguinal Fascia Iliaca Compartment Block in Proximal Femur Fractures: A Randomised Double-blinded Clinical Study

Introduction: Regional anaesthesia techniques such as the Suprainguinal Fascia Iliaca Compartment (S-FICB) block and the Pericapsular Nerve Group (PENG) block provide effective analgesia for patients with hip fractures. The PENG block is considered superior to other hip joint blocks, such as the femoral nerve block and fascia iliaca block, particularly because it preserves quadriceps femoris motor function. Aim: To compare the efficacy of S-FICB and PENG blocks in facilitating optimal positioning of proximal femur fracture patients for spinal anaesthesia. Materials and Methods: This double-blinded, randomised clinical study was conducted at the Department of Anaesthesiology, Government Medical College, Kottayam, Kerala, India. A total of 60 patients aged 18-75 years, belonging to American Society of Anaesthesiologists (ASA) physical status classification I and II, undergoing elective surgery for proximal femur fractures under subarachnoid block, were enrolled. Patients were sequentially allocated into two groups of 30 each. Each group received either S-FICB or PENG block under ultrasound guidance using 20 mL of 0.2% ropivacaine. The primary outcome measure was the difference in Numerical Rating Scale (NRS) pain scores at Rest (NRS-R) and on passive 15° leg lifting (NRS-D), measured every 10 minutes up to 30 minutes after the block in both groups. Secondary outcomes included comparison of Ease of Spinal Positioning (EOSP) scores between PENG and S-FICB groups and evaluation of haemodynamic parameters before and after Peripheral Nerve Block (PNB) and after positioning for Subarachnoid Block (SAB). Categorical variables were analysed using the Chi-square test and continuous variables using Student’s t-test. A p-value