Minimum effective volume of the pericapsular nerve group (PENG) block in association with a standardized obturator nerve block for analgesia in hip osteoarthritis: An up-and-down study
Authors' conclusion
Low-volume PENG block provides effective and motor-sparing analgesia for HOA
Study context
- Population
- Patients with chronic hip osteoarthritis (HOA) pain
- Participants
- 26 patients
- Outcome
- Analgesic success: ≥ 50% reduction in pain during hip flexion
- Follow-up
- 30 min after injection
Methodological detailsprospective, single-centre, Dixon's up-and-down method, ultrasound and fluoroscopic guidance
- Prospective
- Single-centre
- Dixon's up-and-down method
- Ultrasound and fluoroscopic guidance
Main finding
As reported in the abstract
MEV₅₀ of PENG block
- MEV₅₀ estimated at 1.53 mL, combined with a 1 mL obturator nerve injection
Observational data: associations, not effects.
Secondary outcomes
Quadriceps strength and mobility
- Preserved in all patients
Fluoroscopic injectate spread
- Spread between anterior inferior iliac spine and iliopubic eminence
- 100%
- Spread to inferomedial acetabulum
- 58%
- Spread did not correlate with analgesic outcome
Safety
- No adverse events observed
Original publication
Minimum effective volume of the pericapsular nerve group (PENG) block in association with a standardized obturator nerve block for analgesia in hip osteoarthritis: An up-and-down study. J Clin Anesth. Published 24 June 2026. doi:10.
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