TOPLINE:

In patients undergoing ambulatory hip arthroscopy, preoperative pericapsular nerve group block vs sham block did not reduce the use of opioids or improve quality of recovery at 24 hours postoperatively but shortened the stay in the postanesthesia care unit.

METHODOLOGY:

• Researchers conducted a randomized, placebo-controlled trial enrolling 94 patients (mean age, 37.6 years; 56.4% men) with American Society of Anesthesiologists status 1-3 scheduled for elective outpatient hip arthroscopy under general anesthesia.
• Patients were randomly assigned to receive either an ultrasound-guided preoperative pericapsular nerve group block with 20 mL of 0.5% ropivacaine (n = 47) or a sham block with 1 mL of saline injected subcutaneously (n = 47), both performed approximately 30 minutes before surgery.
• All patients received standardized general anesthesia, which included fentanyl or remifentanil at a dosage of 1-2 μg/kg, along with propofol at 2-4 mg/kg intravenously (IV). They also received multimodal analgesia, which consisted of 8 mg of IV dexamethasone, 30 mg of IV ketorolac, and titrated hydromorphone. Postoperative pain was managed using fentanyl and hydromorphone in the postanesthesia care unit, followed by oral oxycodone.
• The primary outcomes were cumulative postoperative opioid consumption (converted to oral morphine milligram equivalents [MMEs]) and quality of recovery, measured using the Quality of Recovery-15 score at 24 hours postoperatively.
• Secondary outcomes included intraoperative opioid use, opioid consumption and length of stay in the postanesthesia care unit, pain scores at rest and with movement, and other variables.

TAKEAWAY:

• Quality of recovery at 24 hours was similar between patients who received the pericapsular nerve group block and those who received the sham block (mean scores, 96.8 vs 101; mean difference, -4.2; adjusted P = .414). Cumulative opioid consumption at 24 hours was also comparable between the two groups (mean, 52.3 vs 52.2 MME; adjusted P = .856).
• Patients who received the pericapsular nerve group block vs the sham block required less opioid analgesia (mean, 37.6 vs 45.7 MME; adjusted mean reduction, approximately 9.5 MME; P = .039) and had a shorter stay (adjusted mean reduction, 20.5 minutes; P = .027) in the postanesthesia care unit.
• Pain scores at rest and with movement decreased over time in both groups, with no consistent differences between them; cumulative opioid consumption at 48 hours also did not differ between groups.
• Opioid-related adverse effects were common within 48 hours. Discomfort during block performance was infrequent and did not differ significantly between the groups. No falls or serious complications associated with the block were observed.

IN PRACTICE:

Routine use of the pericapsular nerve group block for ambulatory hip arthroscopy “cannot be recommended beyond standard multimodal analgesia, although it may be considered selectively to facilitate” early recovery in the postanesthesia care unit in carefully chosen patients, the researchers reported.

SOURCE:

This study was led by Joanne Ming Hui Tan, from the Royal Adelaide Hospital in Adelaide, Australia. It was published online on March 27, 2026, in Regional Anesthesia & Pain Medicine.

LIMITATIONS:

Quadriceps weakness was not measured immediately after surgery, making it hard to accurately determine motor block incidence after the pericapsular nerve group block. A high number of patients chose not to take part in the study, and many of them later received rescue blocks in the postanesthesia care unit. Patient satisfaction at 1 month could not be analyzed because of missing data.

DISCLOSURES:

The authors did not declare a specific grant for this research. One author reported receiving nonclinical time support from the Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network. All other authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.