Effect of Peng Block Application on Inflammation and Mortality in Hip Fractures

Patients over the age of 65 who were scheduled for surgery due to hip fracture were included in the study. According to the power analysis, it was estimated that at least 52 patients would be required for adequate statistical power. Initially, a total of 60 patients were assessed for eligibility and planned to be divided into two groups by randomization. Multimodal analgesia was applied to both groups.

The first group (Group P) received a preoperative Pericapsular Nerve Group (PENG) block, while the second group (Group C) did not receive an analgesic block and was given paracetamol and tramadol hydrochloride for analgesia. All patients received spinal anesthesia using 10 mg of hyperbaric bupivacaine.

Preoperatively, IL-6, CRP, and complete blood count (CBC) tests were performed on all patients, and these tests were repeated 4, 24, and 48 hours after the surgical stimulus. At the end of the operation, total blood loss, transfused blood products and their volumes, and operation time were recorded. Postoperatively, NRS pain scores, time to first analgesic requirement, length of hospital stay, and 30-day mortality were evaluated.

Post-Completion Study Flow

After completion of the study, a total of 60 patients were assessed for eligibility as planned. Of these, 2 patients declined to participate. The remaining 58 patients were randomized into two groups.

In Group P, one patient required conversion to general anesthesia during surgery. In Group C, two patients required intraoperative sedation, and one patient required conversion to general anesthesia. Therefore, four patients were excluded from the final analysis.

As a result, the analyses were conducted on 54 patients in total, with 28 patients in Group P and 26 patients in Group C.

Inclusion criteria

• ASA 1-2-3 score
• Hip Fracture Surgery

Exclusion criteria

• Refusal to participate in the study
• ASA score of 4 and above
• Obesity (BMI >40)
• Failure of spinal block
• Switching to general anesthesia
• Patients undergoing revision surgery
• Patients with multitrauma
• Patients with old fractures (>3 weeks)
• Patients receiving preoperative and intraoperative sedation
• Patients with active malignancy receiving RT, KT
• Patients with active infection, patients receiving antibiotic treatment
• Patients with contraindications for regional anesthesia techniques
• Patients receiving chronic treatment with steroids or immunosuppressants
• Patients using anti-inflammatory drugs