Superiority Randomized Controlled Trial of Ultrasound-guided PENG Block Compared to Surgical Infiltration in the Analgesia of Posterior Total Hip Arthroplasty Surgery

"During surgery, local anesthetics are injected as follow: in the deep plane and in the subcutaneous territory.~Infiltration of the deep plane corresponds to pericotyloid injection, with particular attention to the posterior subcapsular area, the obturator foramen and the psoas muscle. Infiltration of the muscular planes is added, with infiltration of the gluteal and pelvitrochanteric muscles."

"We perform the femoral block under ultrasound after anesthesia (general or rachianesthesia). The PENG block is a peripheral diffusion nerve block that specifically targets the articular divisions of the femoral, obturator and accessory obturator nerves.~The femoral nerve innervates the four parts of the joint capsule, with inconsistency in the anterior inferomedial part of the capsule.~The obturator nerve innervates the inferior part of the anterior face of the capsule.~The accessory obturator nerve innervates the medial half of the hip joint capsule in over 50% of cases."