Pericapsular nerve group block for a child with spina malformation for hip surgery

Abstract

Background: Postoperative pain management after surgery for developmental dysplasia of the hip is a challenge for older children and pediatric patients with epidural block contraindications. Pericapsular nerve group (PENG) block is an innovative technique reported for pain control around the hip joint. We report the application of a PENG block in a child with spina malformation who underwent open hip surgery. Case presentation: A 7-year-old girl with spina bifida and myelomeningocele was scheduled for open left hip surgery. After general anesthesia, the PENG block was performed for perioperative analgesia. No remifentanil was required during the operation. There was no hemodynamic instability during the operation. The patient did not cry awake or report pain, and the numeric rating scale (NRS) score was 1/10 after extubation. No pain, vomiting or nausea was reported in the postoperative recovery area. Up to 24 h after surgery, the pain level was 2/10 with sustained PCIA. Conclusions: In this case, the PENG technique seems to be a safe and satisfying perioperative pain control method for a child with sacrum malformation who underwent unilateral open hip operation. This initial experience encourages the use of the PENG block in hip surgery or other conditions in this specific demographic.

Keywords

• Developmental dysplasia of the hip
• Pericapsular nerve group block
• Pain management
• Pediatrics