Ultrasound Guided Combined Pericapsular Nerve Block with Lateral Femoral Cutaneous Nerve Block or with Supra Inguinal Fascia Iliaca Block Following Fracture Neck Femur Surgery

Background: For perioperative analgesia and early recovery, a combined peripheral nerve block technique may be necessary due to the complex innervation of the hip joint. In order to improve perioperative analgesia in patients undergoing fracture neck femur fixation. Objective: This work aimed to determine the efficacy of two different blocks: one combined with the pericapsular nerve group (PENG) and the other with the supra inguinal fascia iliaca. Methods: Sixty patients of both sexes. All patients were at least 21 years old. All patients had femur fractures in their necks and were undergoing internal fixation and primary, unilateral closure reduction. Patients were divided into two groups according to random assignment: one group had a PENG block and a lateral femoral cutaneous nerves (LFCN) block, while the other group received a PENG block in addition to an iliac fascia supra inguinal block. Results: Both groups had similar analgesia request times, total morphine, and ketorolac use. Both groups had similar visual analog scale measurements. Neither group had substantially different patient satisfaction or postoperative complications. Insignificant differences were seen in MAP, HR, and O2 saturation across groups. Conclusions: One-injection ultrasound-guided PENG with LFCN in femur operations was equivalent to PENG with S. fascia iliaca compartment blocks (FICB) in pain score, opioid intake, time to initial analgesia, patient satisfaction, and complications. PENG with LFCN had greater HR, MAP, and O2 satisfaction than with S. FICB.