Journal of Pain Research (Nov 2024)
Pericapsular Nerve Group (PENG) Block in Pediatric Patients Undergoing Hip and Pelvic Surgical Procedures: An Educational Focused Review
Abstract
Amr Elhamrawy,1 Josiane Kerbage,2 Giorgio Veneziano,3,4 David P Martin,3,4 Joseph D Tobias3,4 1Department of Anesthesiology, Detroit Medical Center/ Wayne State University School of Medicine, Detroit, MI, USA; 2Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA; 3Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 4Department of Anesthesiology & Pain Medicine, the Ohio State University College of Medicine, Columbus, OH, USACorrespondence: Amr Elhamrawy, Department of Anesthesiology, Detroit Medical Center, Wayne State University, 4160 John R St, Detroit, Michigan, 48201, USA, Email [email protected]: Hip disorders in infants and children may result from congenital, infectious, developmental, inflammatory, neoplastic, and traumatic etiologies. Postoperative pain management associated with hip pathologies can be challenging especially due to complex innervation of the hip and surrounding structures. Given the adverse effect profile of systemic opioids, regional anesthesia offers an excellent alternative with more beneficial adverse effect profile. Various peripheral regional anesthetic techniques have been reported with variable results regarding analgesia and differing adverse effect profiles. The pericapsular nerve group (PENG) block is a novel motor-sparing regional anesthetic technique where the local anesthetic agent is deposited in the musculofascial plane between the psoas tendon and the pubic ramus. The main target is the genicular branches of the femoral, obturator, and accessory obturator nerve, which innervate the hip capsule. The anatomy involved with PENG block is reviewed and previous reports of PENG block in pediatric-aged patients, including single shot or continuous catheter techniques, are reviewed.Keywords: regional anesthesia, orthopedic surgery, pediatric anesthesiology, pericapsular nerve group block, lateral femoral cutaneous nerve block
