Nerve Blocks for Pain Management in Hip Surgery
Summary
Nerve blocks have become integral to perioperative analgesia in hip surgery, offering targeted interruption of nociceptive pathways to reduce pain, minimise opioid requirements and enhance early mobilisation. Techniques such as the fascia iliaca compartment block and the pericapsular nerve group block are performed under ultrasound guidance to improve precision and safety. These regional blocks may be delivered as single injections or via continuous infusions, and are typically combined with systemic non-opioid agents in a multimodal regimen. Benefits include reduced postoperative delirium in elderly patients, preservation of quadriceps strength and shorter hospital stays. Advances in ultrasound technology have refined needle placement and local anaesthetic spread, while an expanding evidence base supports tailored block selection according to surgical approach and patient comorbidity. Globally, the rise in hip fracture incidence and elective arthroplasty underscores the practical applications of nerve blocks in reducing health-care costs and improving functional recovery.
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Nerve Blocks for Pain Management in Hip Surgery publication trend
The graph below shows the total number of articles in nerve blocks for pain management in hip surgery across all publications each year (not limited to Nature Index journals).
Technical terms
Pericapsular Nerve Group (PENG) block: An ultrasound-guided interfascial plane block targeting articular branches of the femoral, obturator and accessory obturator nerves to provide analgesia of the anterior hip capsule.
Fascia Iliaca Compartment Block (FICB): A regional anaesthetic technique in which local anaesthetic is deposited beneath the fascia iliaca to block the femoral, lateral femoral cutaneous and obturator nerves.
Multimodal analgesia: A pain-management strategy combining regional techniques, non-opioid medications and, when necessary, opioids to achieve superior analgesia with fewer side effects.
Ultrasound guidance: Use of real-time ultrasonography to visualise anatomical structures and needle trajectory, enhancing accuracy and safety of regional anaesthetic blocks.
Motor-sparing block: A nerve block that provides sensory analgesia while preserving major muscle function, facilitating early mobilisation and reducing fall risk.
References
- Quality of recovery after pericapsular nerve group (PENG) block for primary total hip arthroplasty under spinal anaesthesia: a randomised controlled observer-blinded trial. British Journal of Anaesthesia (2023).
- Fascia iliaca block prophylaxis for hip fracture patients at risk for delirium: a randomized placebo-controlled study. Journal of Orthopaedics and Traumatology (2009).
- Pericapsular Nerve Group (PENG) Block versus Supra-Inguinal Fascia Iliaca Compartment Block for Total Hip Arthroplasty: A Randomized Clinical Trial. Journal of Personalized Medicine (2022).
- A Continuous Infusion Fascia Iliaca Compartment Block in Hip Fracture Patients: A Pilot Study. Journal of Clinical Medicine Research (2012).
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