ULTRASOUND GUIDED PERICAPSULAR NERVE GROUP (PENG) BLOCK FOR HIP SURGERY: A RANDOMIZED CONTROLLED STUDY COMPARING ROPIVACAINE WITH DEXMEDETOMIDINE AND ROPIVACAINE WITH DEXAMETHASONE

Abstract

Background: Hip fractures are prevalent among the elderly and associated with significant morbidity and postoperative pain. Effective regional anesthesia techniques, such as the Pericapsular Nerve Group (PENG) block, can enhance analgesia and facilitate optimal patient positioning for spinal anesthesia. This study was conducted to compare the efficacy of ultrasound-guided PENG block using 0.5% ropivacaine combined with either dexmedetomidine or dexamethasone in patients undergoing hip surgery, focusing on pain relief during patient positioning and duration of postoperative analgesia. Methods: This randomized controlled trial included 48 patients undergoing hip surgery under spinal anesthesia. Patients were randomized into two groups: Group A received ropivacaine with dexamethasone (8 mg), while Group B received PENG block with ropivacaine and dexmedetomidine (1 mcg/kg). Pain scores were measured using the Visual Analog Scale (VAS) at various intervals, including during patient positioning and postoperatively. The duration until first rescue analgesia and total rescue analgesic requirement were also assessed. Results: Group B demonstrated significantly prolonged analgesia (445.0 ± 17.4 min vs. 388.9 ± 19.0 min, p<0.05) and reduced rescue analgesic consumption (1.9 ± 0.6 vs. 2.5 ± 0.7, p<0.05) compared to Group A. No significant differences were found in intraoperative hemodynamics or adverse effects. Conclusion: PENG block is effective for facilitating patient positioning for spinal anesthesia. Adding dexmedetomidine to ropivacaine prolongs postoperative analgesia and reduces analgesic requirements more effectively than dexamethasone