Efficacy and safety of pericapsular nerve group block in total hip arthroplasty: a meta-analysis and systematic review

INTRODUCTION: Ensuring effective perioperative pain control is a crucial aspect of rehabilitation programs following total hip arthroplasty. This study presents a comprehensive meta-analysis and systematic review to assess the efficacy and safety of pericapsular nerve group block (PENG) in the context of total hip arthroplasty.EVIDENCE ACQUISITION: A systematic search was conducted in multiple databases, including PubMed, Embase, Cochrane Library, and Web of Science, to identify relevant randomized controlled studies investigating the efficacy and safety of PENG for total hip arthroplasty. The search was conducted up until 1st June 2023. Data analysis was performed using Stata v. 15.0.EVIDENCE SYNTHESIS: A total of 721 individuals participated in this study, which included 13 randomized controlled trials. Among them, 377 individuals were assigned to the experimental group, while 344 individuals were assigned to the control group. The findings from the meta-analysis indicated that the application of PENG yielded favorable outcomes in terms of reducing six-hour pain scores (SMD=-0.63, 95% CI-1.18,-0.09) and 24-hour pain scores (SMD=-1.45, 95% CI-2.51,-0.29). Moreover, it was found to decrease opioid consumption (SMD=-0.84, 95% CI-1.35,-0.34), without causing a significant increase in nausea and vomiting (RR=0.75, 95% CI 0.45, 1.23) or urinary retention (RR=2.46, 95% CI 0.49, 12.31). CONCLUSIONS: Based on the latest findings, PENG has been shown to effectively decrease pain scores within six and 24 hours following total hip arthroplasty. However, its effectiveness in pain control diminishes after 48 hours. Addition-ally, PENG has demonstrated the ability to reduce opioid consumption without an accompanying increase in adverse drug events.