Effect of pericapsular nerve group block on postoperative cognitive function in older patients undergoing total hip arthroplasty
- 20.02.2026
- Originalien
Erschienen in:
- Verfasst von
- Gokhan Erdem
- Burak Nalbant
- Fatma Kavak Akelma
- Enes Sağlam
- Dilara Erdem
- Ayşe Lafçı
- Erschienen in
- Die Anaesthesiologie | Ausgabe 4/2026
Abstract
Purpose
Postoperative cognitive dysfunction (POCD) is common in older patients undergoing orthopedic surgery and may hinder clinical recovery. This prospective study evaluated whether a preoperative pericapsular nerve group (PENG) block reduces POCD incidence in patients undergoing total hip arthroplasty (THA).
Methods
This prospective, randomized, double-blind study included older patients scheduled for elective THA under spinal anesthesia. Patients were randomized into 2 groups: PENG (group P) and control (group C). Group P underwent an ultrasound-guided PENG block containing 20 mL of 0.25% bupivacaine, while group C received a sham block. Cognitive performance was evaluated using the telephone version of the Mini-Mental State Examination (T-MMSE) preoperatively and on postoperative days 7, 30 and 90. We evaluated postoperative pain using the numerical rating scale (NRS) and recorded opioid consumption, time to mobilization, hospital stay duration, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR).
Results
The final analysis included 84 patients (41 in group P and 43 in group C). There were no significant differences in demographic characteristics or intraoperative data between the groups (p > 0.05). The incidence of POCD on postoperative day 7 was lower in the PENG group (14.6% vs. 37.2%; p < 0.05). In the first 24h postoperatively group P reported significantly lower pain scores and opioid use (p < 0.001), were mobilized earlier and discharged sooner (p < 0.001). The NLR and PLR were lower in the PENG group at 24 and 48h postoperatively (p < 0.05).
Conclusion
Preoperative PENG block may preserve early postoperative cognitive function in THA patients, through improved analgesia, reduced opioid consumption, attenuation of systemic inflammation, early mobilization and shorter hospital stay.
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- Titel
- Effect of pericapsular nerve group block on postoperative cognitive function in older patients undergoing total hip arthroplasty
- Verfasst von
-
Gokhan Erdem
Burak Nalbant
Fatma Kavak Akelma
Enes Sağlam
Dilara Erdem
Ayşe Lafçı
- Publikationsdatum
- 20.02.2026
- Verlag
- Springer Medizin
- Erschienen in
-
Die Anaesthesiologie / Ausgabe 4/2026
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866 - DOI
- https://doi.org/10.1007/s00101-026-01654-6
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