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Benefits of Using the Pericapsular Nerve Group (PENG) Block

By Nathaniel Leu, MD, MS; Josh Luftig, PA; Daniel Mantuani, MD, MPH; Maximiliano Sobrero, MD; and Arun Nagdev, MD | on February 17, 2022 | 0 Comment
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IMAGES: Arun Nagdev Illustrations: Luftig/Benbott/Highland Ultrasound

A Simple, Safe, and Valuable Tool

The PENG block is a simple, safe block that can be applied to a wide variety of painful pelvic injuries. It is unique in that this block provides pain control to hip and pelvic fractures and can be a valuable tool for multimodal pain control in the acute setting. This block may provide superior analgesia to hip fractures compared to the traditionally performed FNB/FIBs. Like other ultrasound-guided nerve blocks, the clinician should be knowledgeable about the surrounding anatomy and comfortable with needle visualization. 

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Explore This Issue
ACEP Now: Vol 41 – No 02 – February 2022

Dr. Leu and Dr. Sobrero are both ultrasound fellows at Highland Hospital; Josh Luftig, PA, is a clinical instructor at Highland Hospital; Dr. Mantuani is the ultrasound fellowship director at Highland Hospital; and Dr. Nagdev is director of the ultrasound division at Highland Hospital.

References

  1. Healthcare cost and utilization project (HCUP). Agency for Healthcare Research and Quality website. Accessed Dec. 1, 2021.
  2. Bentler SE, Liu L, Obrizan M, et al. The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol. 2009;170(10):1290-1299.
  3. Titler MG, Herr K, Schilling ML, et al. Acute pain treatment for older adults hospitalized with hip fracture: current nursing practices and perceived barriers. Appl Nurs Res. 2003;16(4):211-227.
  4. Beaudoin FL, Haran JP, Liebmann O. A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial. Acad Emer Med. 2013;20(6):584-591.
  5. Ritcey B, Pageau P, Woo MY, et al. Regional nerve blocks for hip and femoral neck fractures in the emergency department: a systematic review. CJEM. 2015;18(1):37-47.
  6. Luftig J, Dreyfuss A, Mantuani D, et al. A new frontier in pelvic fracture pain control in the ED: successful use of the pericapsular nerve group (PENG) block. Amer J Emerg Med. 2020;38(12):2761.e5-2761.e9.
  7. Short AJ, Barnett JJG, Gofeld M, et al. Anatomic study of innervation of the anterior hip capsule: implication for image-guided intervention. Reg Anesth Pain Med. 2018;43(2):186-192.
  8. Acharya U, Lamsal R. Pericapsular nerve group block: an excellent option for analgesia for positional pain in hip fractures. Case Rep Anesthesiol. 2020;2020:1830136.
  9. Carr M, Hoffman T, Lin J. Pericapsular nerve group (PENG) block for patients with hip or pelvis fractures in the ED. ACEP Emergency Ultrasound Section website. Accessed Dec. 1, 2021.
  10. What med? Highland Ultrasound website. Accessed Aug. 13, 2021.
  11. Local anesthetic dosing calculator. MDCalc website. Accessed Nov. 24. 2021.
  12. Weinberg G. LipidRescue website. Accessed Nov. 24, 2021.
  13. Schultz C, Yang E, Jefferson J, et al. Tips for performing ultrasound-guided nerve blocks in the emergency department. ACEP Now. 2021;40(6).

Pages: 1 2 3 4 5 | Single Page

Topics: Nerve Blockspericapsular nerve group (PENG) block

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