Arthroscopy - 2026-05-14 - Journal Article; Review
Pericapsular Nerve Group Block Improves Pain Control Compared With No Block in Patients Undergoing Hip Arthroscopy Surgery: A Systematic Review.
Qureshi AA, Kothari T, Rodriguez GG, Lee MS, Pettinelli NJ, Rosa R, Park N, Gillinov SM, Surucu S, Norman M, Moran J, Jimenez AE
Topics
Key Takeaway
PENG block reduced PACU stay by 28–60 minutes and lowered postoperative pain scores in 5 of 6 studies versus no block, but opioid reduction was inconsistent (0–2 mg morphine equivalents) across 11 studies totaling 386 patients.
Summary Depth
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Summary
This PRISMA-adherent systematic review evaluated whether PENG block improves postoperative pain and reduces opioid consumption in hip arthroscopy patients. Eleven studies (386 patients, mean age 26.5–44.1 years) were analyzed using Cochrane RoB2 and MINORS quality tools. PENG block outperformed no block on pain scores in 5/6 studies and reduced PACU time by 28–60 minutes, but opioid reduction was significant in only 5/8 reporting studies with a clinically modest range of 0–2 mg morphine equivalents.
Key Limitation
The total cohort of only 386 patients across heterogeneous study designs prevents meta-analysis and leaves opioid-sparing conclusions statistically inconclusive.
Original Abstract
PURPOSE
To evaluate the impact of the pericapsular nerve group (PENG) block on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy.
METHODS
A systematic literature review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in July 2025. PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were searched using the terms "pericapsular" and "hip." Primary research studies reporting pain scores and postoperative opioid consumption in hip arthroscopy patients receiving PENG blocks were included. Study quality was assessed using the Cochrane Risk-of-Bias Tool 2 for randomized controlled trials and the methodological index for nonrandomized studies criteria for nonrandomized studies.
RESULTS
Eleven studies with a total of 386 patients met the inclusion criteria. The mean age of patients ranged from 26.5 ± 10.4 to 44.1 ± 13.7 years. Five studies revealed that PENG blocks significantly reduced postoperative opioid consumption, whereas 3 studies reported no significant difference. Reductions in opioid consumption in the postanesthesia care unit ranged from 0 to 2 mg morphine equivalents. PENG block showed significant postoperative pain benefit compared with the fascia iliaca block, but no significant postoperative pain benefit compared with other nerve blocks. Pain scores in the PENG block group were significantly lower in 5 out of 6 studies when compared with a control group with no nerve block. Additionally, the PENG block reduced postanesthesia care unit stay times in 5 studies, with average reductions ranging from 28 to 60 minutes compared with no nerve block.
CONCLUSIONS
The PENG block improves postoperative pain control and reduces opioid consumption in patients undergoing hip arthroscopy, particularly when compared with no peripheral nerve block.
LEVEL OF EVIDENCE
Level III, systematic review of Level I and III studies.