The comparison of spread of methylene blue after the Pericapsular Nerve Group block and a double injection selectively targeting the articular branches to the anterior hip capsule in human cadavers

Pain Pract. 2025 Feb;25(2):e70002. doi: 10.1111/papr.70002.

Abstract

Objectives: In this study, the spread of methylene blue was compared between an ultrasound-guided Pericapsular Nerve Group (PENG) block and a double injection technique, where the approach towards the inferomedial acetabulum was added to the latter.

Methods: The two techniques were performed in 11 fresh frozen cadavers. The spread was measured after anatomical dissection in which the supplying femoral and obturator nerves were identified.

Results and conclusion: Our study demonstrates adequate staining of the iliac bone with comparable distal and medial spread in both techniques, indicating that the PENG block with a single injection is adequate in blocking the hip capsule with 10 mL local anesthetics. Staining of the femoral nerve occurred in 2/6 specimens after the PENG block, and staining of the obturator nerve in 1 specimen in each group.

Keywords: PENG block; analgesia; denervation; joint pain; local anesthesia.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / administration & dosage
  • Cadaver*
  • Female
  • Femoral Nerve / diagnostic imaging
  • Femoral Nerve / drug effects
  • Hip Joint / innervation
  • Humans
  • Joint Capsule / drug effects
  • Male
  • Methylene Blue* / administration & dosage
  • Nerve Block* / methods
  • Obturator Nerve / anatomy & histology
  • Obturator Nerve / diagnostic imaging
  • Obturator Nerve / drug effects

Substances

  • Methylene Blue
  • Anesthetics, Local