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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ACEP Now: Vol 41 – No 02 – February 2022Dr. 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
- Healthcare cost and utilization project (HCUP). Agency for Healthcare Research and Quality website. Accessed Dec. 1, 2021.
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- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- What med? Highland Ultrasound website. Accessed Aug. 13, 2021.
- Local anesthetic dosing calculator. MDCalc website. Accessed Nov. 24. 2021.
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- Schultz C, Yang E, Jefferson J, et al. Tips for performing ultrasound-guided nerve blocks in the emergency department. ACEP Now. 2021;40(6).
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