Korean J Anesthesiol.  2024 Oct;77(5):565-569. 10.4097/kja.24232.

Utilization of the pericapsular nerve group block in preoperative rehabilitation of patients with femoral neck fractures -a case series-

• Jin Z
• Sugiyama D
• Higo F
• Hirata T
• Kobayashi O
• Morimatsu H
• Ueda K

• KMID: 2559509
• DOI: http://doi.org/10.4097/kja.24232

Abstract

Background
Elderly patients with femoral neck fractures, particularly those with severe comorbidities or living in regions with limited medical resources, may experience delays in surgical treatment. Although the benefits of preoperative rehabilitation (prehabilitation) in hip arthroplasty have been reported, pain management remains a challenge. The pericapsular nerve group (PENG) block, known for its exceptional analgesic effect and motor function preservation, may be a promising intervention during prehabilitation in these patients. Case: We enrolled ten patients with Garden classification 3–4 femoral neck fractures scheduled for hip arthroplasty. After receiving a PENG block with 20 ml of 0.375% ropivacaine, all patients underwent initial prehabilitation sessions comprising 9 mobility levels, ranging from bed-sitting to walking. One patient was excluded due to experiencing high blood pressure during prehabilitation. Six of the nine remaining patients (66.7%) were successfully transferred from bed to wheelchair.
Conclusions
The PENG block enhanced prehabilitation for patients with femoral neck fractures undergoing hip arthroplasty.

Keyword

Femoral neck fractures; Hip fractures; Nerve block; Prehabilitation; Preoperative rehabilitation; Regional anesthesia