Introduction. Postoperative pain after hip fracture surgery leads to immobility, hospital stay, and use of NSAIDs and opioids. PENG block may offer better analgesia than fascia iliaca block. Objective. To compare the need for rescue use with NSAIDs or opioids and the duration of postoperative analgesia with PENG block versus fascia iliaca in the HGR1 Morelia. Methods. A retrospective, observational, descriptive study (March–June 2025) was performed. Seventy patients (age 57.1±16.0 years) who underwent hip fracture surgery with a PENG block (n=44) and fascia iliaca (n=26) were analyzed. Outcomes included rescue use (NSAID/opioid) and time to first rescue. Covariates included age, sex, ASA, anesthetic technique, and type of surgery. Analyses included χ²/Fisher, Kaplan–Meier, logrank, RMST 0–24 h, and Cox (α=0.05). Results. 7/44 (15.9%) patients required rescue with PENG and 17/26 (65.4%) with fascia (p<0.001); RR=0.24, OR=0.10, ARR=49.5 pp, NNT≈2. In terms of survival, PENG did not reach the median (≥24 h) and S(24 h)=0.84; fascia showed a median of 10.0 h and S(24 h)=0.35 (log-rank p<0.001). RMST 0–24 h: 21.86 h (PENG) vs 13.50 h (fascia), Δ=+8.36 h. Unadjusted Cox: HR (Fascia vs PENG) =6.40 (p=4.2×10⁻⁵). Exploratory: older age was associated with earlier rescue. Conclusions. In this cohort, PENG provided longer-lasting analgesia and substantially reduced the need for rescue NSAIDs or opioids versus fascia iliaca during the first 24 h, with clinical relevance (NNT ≈2) and consistency in time metrics (KM, RMST, HR). It is recommended that PENG be prioritized within multimodal analgesia and that these findings be confirmed with adjusted analyses and prospective studies.
Introducción. El dolor posoperatorio tras cirugía por fractura de cadera condiciona inmovilidad, estancia hospitalaria y consumo de aines y opioides. El bloqueo PENG podría ofrecer mayor analgesia que el bloqueo de fascia ilíaca. Objetivo. Comparar la necesidad del uso de rescate con AINES u opioides y la duración de la analgesia posoperatoria con bloqueo PENG versus fascia ilíaca en el HGR1 Morelia. Métodos. Estudio observacional retrospectivo, descriptivo (marzo–junio 2025). Se analizaron 70 pacientes (edad 57.1±16.0 años) operados por fractura de cadera con bloqueo PENG (n=44), fascia ilíaca (n=26). Desenlaces: uso de rescate (AINE/opioide) y tiempo al primer rescate. Covariables: edad, sexo, ASA, técnica anestésica y tipo de cirugía. Análisis: χ²/Fisher, Kaplan–Meier, log-rank, RMST 0–24 h y Cox (α=0.05). Resultados. Requirieron rescate 7/44 (15.9%) con PENG y 17/26 (65.4%) con fascia (p<0.001); RR=0.24, OR=0.10, ARR=49.5 pp, NNT≈2. En supervivencia, PENG no alcanzó la mediana (≥24 h) y S(24 h)=0.84; fascia mostró mediana 10.0 h y S(24 h)=0.35 (log-rank p<0.001). RMST 0–24 h: 21.86 h (PENG) vs 13.50 h (fascia), Δ=+8.36 h. Cox no ajustado: HR (Fascia vs PENG) =6.40 (p=4.2×10⁻⁵). Exploratorio: mayor edad se asoció con rescate más temprano; Conclusiones. En esta cohorte, PENG proporciona analgesia más duradera y reduce sustancialmente la necesidad de rescate de aines u opioides frente a fascia ilíaca durante las primeras 24 h, con relevancia clínica (NNT≈2) y consistencia en métricas temporales (KM, RMST, HR). Se recomienda priorizar PENG dentro de una analgesia multimodal y confirmar estos hallazgos con análisis ajustados y estudios prospectivos.
