Pericapsular Nerve Group Block in Combination with Lateral Femoral Cutaneous Nerve and Sacral Plexus Blocks for Hip Fracture: A Case Series

Background Regional anesthetic techniques for hip fracture are critical for pain control, reducing perioperative adverse events, and minimizing postoperative opioid use. This case series investigates the use of a novel triple-block protocol—ultrasound-guided pericapsular nerve group (PENG) block, lateral femoral cutaneous nerve (LFCN) and sacral plexus blocks—in patients with hip fractures, focusing on its feasibility as an anesthetic strategy for high-risk hip fracture patients. Case Presentation Five frail elderly patients with significant comorbidities and contraindications to neuraxial anesthesia underwent bipolar femoral head replacement surgery. Primary outcomes included anesthesia quality (0-3 scale: poor, acceptable, good, excellent) and postoperative analgesia. Secondary outcomes encompassed surgical conditions, complications, and patient satisfaction. Results These combined blocks provided effective analgesia (Visual Analog Scale, [VAS] scores of 0-1 at PACU discharge) and preserved quadriceps motor function (Medical Research Council [MRC] scale 4-5). Surgical conditions were rated “excellent” in four cases and “acceptable” in one. Postoperative sufentanil consumption was low (36-83 μg via patient-controlled analgesia [PCA]). Complications included one case of surgical site dehiscence (requiring reoperation) and transient dizziness. Conclusion This triple-block technique offers comprehensive analgesia for high-risk hip fracture patients or those with contraindications to neuraxial anesthesia, enabling early mobilization and reducing opioid reliance. Larger randomized trials are warranted to confirm these findings.

• Publication year

  2025

• Venue

  Journal of Pain Research

• Publication date

  2025-08-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.2147/JPR.S517762PMID 40766098PMCID 12323795
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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