EFFICACY OF 0.25% BUPIVACAINE AND 0.2% ROPIVACAINE IN PERICAPSULAR NERVE GROUP BLOCK IN POSITIONING FOR SPINAL ANAESTHESIA.

Hip fractures are common among the elderly due to age-related osteoporosis and degenerative changes. Effective analgesia is crucial for facilitating patient positioning for spinal anaesthesia and ensuring perioperative comfort. The Pericapsular Nerve Group (PENG) block is a promising regional anaesthetic technique that targets the articular branches of the hip joint, providing effective analgesia

Methods: A total of 60 patients were randomly allocated into two groups: Group B received 20 ml of 0.25% Bupivacaine and Group R received 20 ml of 0.2% Ropivacaine. The PENG block was performed under ultrasound guidance using a low-frequency curvilinear probe and a 22G, 120 mm needle. Visual Analogue Scale (VAS) scores at rest and during movement were assessed 10 minutes after block administration and during positioning for spinal anaesthesia. Postoperative pain was evaluated at 10, 30, and 60 minutes, then hourly for 6 hours, every 2 hours for the next 6 hours, and every 4 hours up to 24hours post-procedure.

Results: The PENG block effectively provided analgesia in both groups. Most patients experienced good pain relief preoperatively and postoperatively. However, Group R (Ropivacaine) demonstrated lower mean VAS scores and longer duration of analgesia compared to Group B (Bupivacaine), indicating superior analgesic efficacy.

Conclusion: The PENG block is an effective method for achieving preoperative and postoperative analgesia in elderly patients undergoing hip fracture surgery. Ropivacaine (0.2%) provides superior pain control and a longer duration of analgesia than Bupivacaine (0.25%), making it a more effective choice in this clinical context.