{
  "abstract": "Background and Aims Hip fracture surgery is associated with severe preoperative pain, which can hinder positioning for spinal anesthesia and negatively impact patient experience. Preemptive analgesia, delivered prior to the noxious surgical stimulus, plays a crucial role in reducing central sensitization and optimizing perioperative comfort. The Pericapsular Nerve Group (PENG) block is a promising regional technique targeting the anterior capsule of the hip causing the pain. To assess the immediate analgesic effect of ultrasound-guided PENG block performed before spinal anesthesia in patients undergoing surgery for femoral neck fracture.Methods In a monocentric prospective study, 66 patients aged over 65 years with femoral neck fractures were included. Each patient received a echoguided PENG block with 20 ml of bupivacaine 0.25% before unilateral spinal anesthesia as part of an ERAS protocol. . Pain intensity was measured using the Numeric Rating Scale (NRS) at baseline (H0), 15 minutes post-block (H15), and before mobilisation for spinal anesthesia. Additional outcomes included technical feasibility, block onset time, and tolerance.Results The PENG block was performed successfully in all cases, with a mean execution time of 8.56 ± 3.18 minutes. NRS scores dropped significantly from a baseline mean of 7.1 ± 1.2 to 1.8 ± 0.9 at H15 (p < 0.001). No rescue analgesia was required for spinal positioning in 96.8% of patients. The procedure was well tolerated, with no block-related complications.Conclusions The PENG block provides rapid, effective preemptive analgesia in hip fracture patients, significantly reducing pain before spinal anesthesia. Its motor-sparing profile and safety make it an ideal component of ERAS pathways, especially in elderly and fragile patients.",
  "authors": [
    {
      "affiliations": [
        "Anaesthesia and Intensive Care Department, Faculté de Médecine/Université 3 de Constantine, Constantine, Algeria"
      ],
      "name": "Naouel Hamma"
    },
    {
      "affiliations": [
        "Epidemiology Departement, Faculté de Médecine/Université 3 de Constantine, Constantine, Algeria"
      ],
      "name": "Abdelhak Lalkhel"
    },
    {
      "affiliations": [
        "Chu Constantine, Constantine, Algeria"
      ],
      "name": "Assya Benahbiles"
    },
    {
      "affiliations": [
        "Anaesthesia and Intensive Care Department, Faculté de Médecine/Université 3 de Constantine, Constantine, Algeria"
      ],
      "name": "Hichem Makhloufi"
    }
  ],
  "title": "EP138 Preemptive analgesia with PENG block: immediate pain relief before spinal anesthesia for hip fracture surgery",
  "uid": "54f61e82-0d55-5fb6-8cbc-aa750f6c2fd2"
}