Effect of PENG Block on Postoperative Tramadol Consumption in Partial Hip Prosthesis Surgery

Postoperative pain management in hip surgery remains a significant clinical challenge, particularly in elderly patients. Effective analgesia is essential to reduce opioid consumption, improve patient comfort, and enhance recovery. The pericapsular nerve group (PENG) block is a relatively new regional anesthesia technique that targets the articular branches of the femoral, obturator, and accessory obturator nerves, providing analgesia to the anterior hip capsule.

This prospective study was conducted to compare the clinical effects of PENG block in patients undergoing partial hip prosthesis surgery under general anesthesia. A total of 48 patients aged between 18 and 75 years were included and divided into two groups: the PENG group (Group P), which received ultrasound-guided PENG block with 20 mL of 0.5% bupivacaine after induction of general anesthesia, and the control group (Group K), which received general anesthesia alone.

Demographic data, intraoperative anesthetic requirements, and postoperative parameters were recorded. The primary outcome measure was total tramadol consumption within the first 24 hours after surgery. Secondary outcomes included postoperative pain scores (VAS and NRS), hemodynamic parameters (mean arterial pressure and heart rate), remifentanil consumption, need for additional analgesia, bispectral index (BIS) values, patient comfort score, modified Aldrete recovery score, Riker agitation-sedation scale, and incidence of complications such as nausea, vomiting, hypotension, hypertension, and arrhythmia.

The results of this study are intended to evaluate the effectiveness of PENG block as a component of multimodal analgesia and to determine its impact on opioid consumption and postoperative recovery in patients undergoing hip surgery.

Inclusion criteria

• Patients aged between 18 and 75 years
• Patients scheduled for partial hip prosthesis surgery
• Patients classified as ASA physical status I-III
• Patients who provided written informed consent

Exclusion criteria

• Known allergy to local anesthetics
• Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia
• Infection at the injection site
• Severe systemic disease (ASA IV or higher)
• Cognitive impairment preventing reliable pain assessment
• Refusal to participate in the study