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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(06): e932-e938
DOI: 10.1055/s-0043-1776909
Artigo Original
Quadril

Accuracy of Hip Pericapsular Nerve Block (PENG) without Ultrasound Aid in Patients with Hip Pain

Article in several languages: português | English

Authors

  • Giancarlo Cavalli Polesello 

    1   Médico Professor Adjunto Livre Docente da Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brasil

  • André Sanches Saú

    2   Médico estagiário do Grupo de Quadril do Departamento de Ortopedia e Traumatologia da Irmandade Santa Casa de Misericórdia de São Paulo, SP, São Paulo, Brasil

  • Marco Rudelli

    3   Médico assistente do Núcleo de Apoio à Pesquisa em Análise do Movimento (NAPAM), São Paulo, SP, Brasil

  • Walter Ricioli Junior

    3   Médico assistente do Núcleo de Apoio à Pesquisa em Análise do Movimento (NAPAM), São Paulo, SP, Brasil

  • Nayra Deise dos Anjos Rabelo

    4   Fisioterapeuta, Professora Doutora Núcleo de Apoio à Pesquisa em Análise do Movimento (NAPAM), São Paulo, SP, Brasil


Financial Support This study did not receive any financial support from public, commercial or non-profit sources, commercial or non-profit sources.
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Abstract

Objective To describe and evaluate the accuracy of the pericapsular nerve group (PENG) block technique with no ultrasound guidance.

Method Series of 40 infiltrations in patients with hip pain undergoing outpatient follow-up in the hip surgery group or admitted to the emergency room from a hospital in São Paulo, SP, Brazil. The hip PENG technique was guided by palpable anatomical pelvic structures, with no ultrasound orientation for needle positioning, using the equipment only to check the correct location after an unguided puncture.

Results In the 40 hips infiltrated from 35 patients with a mean age of 59.2 years, the success rate was 85%. Among the mispositioned cases, 71.4% occurred in the first 13 applications and 28.6% in the subsequent 27 applications. In all patients, the neurovascular bundle was in the medial third of the pen-made demarcation. Even in cases with a failed needle location, the distance from the neurovascular bundle was safe. A single adverse effect occurred, with spontaneous improvement of the femoral nerve apraxia within two days.

Conclusion Unguided PENG block is a viable technique for a physician knowledgeable about its application in services with no ultrasound availability.

Keywords

analgesia - anesthesia - nerve block - hip fractures - pain management

Study developed at the Hip Group, Department of Orthopedics and Traumatology, Faculdade de Ciências Médicas Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brazil.




Publication History

Received: 14 September 2022

Accepted: 18 January 2023

Article published online:
08 December 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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