Sacral Erector Spinae Plane Block Versus Pericapsular Nerve Group Block For Analgesia In Hip Hemiarthroplasty: A Randomized Comparative Study

What this Trial Is About

This research aims to compare two types of nerve blocks, sacral erector spinae plane block (S-ESPB) and pericapsular nerve group (PENG) block, for pain relief after hip hemiarthroplasty in patients aged 50 to 90 years with femoral neck fractures. These blocks are being studied because they may provide effective pain control while preserving muscle strength, aligning with recovery protocols that emphasize pain management, limited opioid use, and early movement to reduce complications. Participants will be randomly assigned to receive either the sacral ESPB or the PENG block after spinal anesthesia and before surgery begins. The sacral ESPB is performed with the patient lying on their side, while the PENG block is done with the patient lying on their back. Both blocks use ultrasound guidance to accurately place local anesthetic near targeted nerves, with strict safety measures to avoid toxicity and adverse events. All patients will receive standard spinal anesthesia and a uniform pain medication plan including paracetamol, NSAIDs, and opioids if needed. During the study, patients will be monitored for pain levels using a numeric rating scale at rest and during movement at multiple times within 24 hours after surgery. Other measures include opioid use, timing of first rescue pain medication, ability to participate in physiotherapy, delirium signs, motor function, side effects linked to opioids, and hospital stay length. Safety monitoring will check for block-related complications and adverse reactions. Total participation covers the surgery day and up to 30 days of follow-up for hospital discharge assessment.

Sacral ESPB vs. PENG Block for Hip Hemiarthroplasty Analgesia