Hip fractures are common orthopedic problems associated with significant morbidity and mortality. As a definitive treatment, most patients with fractured hips would undergo early reduction and surgical fixation (1). The majority of hip fractures in the elderly population results from an inadvertent fall, whereas, it is more commonly caused due to a high energy trauma in the younger and adult population (2). Irrespective of the etiology, hip fractures are a painful condition, and early pain relief and definitive management is of utmost importance, especially in the elderly population. Hip surgery is often accompanied by severe pain-induced postoperative adverse effects, such as enhanced blood pressure, delayed mobility, delirium, and deep vein thrombosis. As a result, patients require large opioid doses for pain relief, which, in turn, induce drug-related complications like nausea, vomiting, itching, and respiratory inhibition, which are not conducive to patient recovery. (3) Central neuraxial blockade is the most common anaesthetic technique for hip surgical procedures. Patients with hip fracture experience excruciating pain, which would prevent the ideal positioning of the patient for the neuraxial blockade . (4) There is growing interest in using regional nerve blocks for pain reduction in the elderly with fractured hip. Femoral nerve block (FN), Fascia Iliaca block (FIB), and 3-in-1 FN block were formerly used to treat hip fractures. These blocks provided perioperative analgesia and reduced the patient’s postoperative opioid requirement . (5) Although FNB and FICB provides adequate analgesia for patients, it has certain limitations, such as incomplete block and lower limb muscle weakness. The anterior capsule of the hip joint is mainly supplied by branches of the femoral nerve (FN), obturator nerve (ON), and accessory obturator nerve (AON). Literature suggests that the obturator nerve is not covered in these blocks. The core of hip analgesia is the anterior capsule, and FN, ON, and AON are the keys to block (6) PENG, a new regional block technique introduced by Girón Arango et al. (7) in 2018.Available evidence suggests that the PENG block has shown some promise in cases undergoing hip surgery . (8) We have planned this study to compare the pre operative and post operative analgesic efficacy of USG guided PENG block with Ropivacaine vs Ropivacaine with Dexamethasone for elective hip surgery. |