Hey guys, thank you so much for your site and information. I have been to a couple of your workshops in Chicago and now following you through your site here. Im looking for some help with our total hips. Ive been doing spinals and did a couple fascia iliaca blocks which had too much motor weakness to ambulate with therapy DOS secondary to the block. Ive been reading about the PENG block and was wondering if that is something that you guys have tried and what success you may have had?

Thank you,
Dean

Hi Dean. Good to hear from you. Yes we have tried both of those and ESP blocks. I agree the FI has too much motor block but has the best analgesia. There was a recent article in RAPM comparing FI and PENG and it confirmed what we have seen. We have settled for the PENG with less analgesia but without motor weakness for now. We are still evaluating ESP blocks and our initial data makes it seem similar to the PENG block. I wish the PENG had better analgesia but doing outpatient total hips it is hard to justify a femoral block with quad weakness from an FI. They have enough falls without that!

Thank you. Guess I will follow on with the PENG then. Thankfully with the multimodal combo our pain scores and discharge times are a pretty good approach.

Agree. The multimodal approach is very important on this one.