ULTRASOUND GUIDED PERICAPSULAR NERVE GROUP BLOCK VERSUS ULTRASOUND GUIDED CAUDAL BLOCK FOR POSTOPERATIVE PAIN IN PAEDIATRIC HIP SURGERY

Abstract

Paediatric hip surgeries such as open reduction for developmental dysplasia of the hip (DDH) lead to extensive injuries and severe pain. Perioperative pain control is of paramount importance during paediatric hip surgery. Caudal block is a common technique used for perioperative pain relief in paediatric lower limb surgeries but despite the success of neuraxial blocks in decreasing postoperative pain scores in paediatric patients undergoing hip surgery, positioning requirements, bilateral sensory and motor blockade, and urinary retention limit their use. Among peripheral nerve block techniques used for relieving pain associated with hip fracture, femoral nerve (FN) block, fascia iliaca compartment (FIC) block and 3-in-1 FN block are widely used. However, these techniques have often failed to provide adequate block of the obturator nerve (ON) and the accessory obturator nerve (AON). The pericapsular nerve group (PENG) block, first described by Girón-Arango et al. in 2018, has emerged as a promising alternative for hip analgesia. This ultrasound-guided block selectively targets the articular branches of the femoral, obturator, and accessory obturator nerves, which provide sensory innervation to the anterior hip capsule. While its use has been well-documented in adult patients with hip fractures, evidence supporting its efficacy in the paediatric population remains limited