Anesthesia or analgesia? New block for shoulder surgery: pericapsular nerve group block
Interscalene brachial plexus (ISB) block is considered the analgesic technique of choice for shoulder surgery. However, the hemidiaphragmatic paresis that may occur after the block has led to the search for an alternative to the ISB block. In this case report, the pericapsular nerve group (PENG) block was performed for both surgical anesthesia and postoperative analgesia in two patients who underwent shoulder surgery. It is suggested that the PENG block can be safely applied for analgesia and can be part of surgical anesthesia, but alone is not sufficient for anesthesia. The block of this area did not cause motor block or pulmonary complications, nor result in muscle laxity, blocking only the shoulder and the upper third of the humerus. It was demonstrated that the PENG block may be safely applied for both partial anesthesia and analgesia in selected shoulder surgery cases.
1 M.S. Patel, J.A. Abboud, P.M. Sethi Perioperative pain management for shoulder surgery: evolving techniques J Shoulder Elbow Surg. (2020)
2 R. Sripada, C Bowens Jr Regional anesthesia procedures for shoulder and upper arm surgery upper extremity update--2005 to present Int Anesthesiol Clin., 50 (2012), pp. 26-46
3 E. Yamak Altinpulluk, A.S. Teles, F. Galluccio, et al. Pericapsular nerve group block for postoperative shoulder pain: A cadaveric radiological evaluation J Clin Anesth., 67 (2020), Article 110058
4 J. Tran, P.W.H. Peng, A.M.R. Agur Anatomical study of the innervation of glenohumeral and acromioclavicular joint capsules: implications for image-guided intervention Reg Anesth Pain Med. (2019), pp. rapm-2018-100152
5 P. Casas Reza, P. Dieguez Garcia, M. Gestal Vazquez, L. Sampayo Rodriguez, S. Lopez Alvarez Pericapsular nerve group block for hip surgery Minerva Anestesiol., 86 (2020), pp. 463-465