Meta-Analysis of PENG+LFCN versus FICB on ERAS-Related Outcomes: Postoperative Pain, Motor Function and Recovery in Hip Surgery

J Invest Surg. 2026 Dec;39(1):2663595. doi: 10.1080/08941939.2026.2663595. Epub 2026 May 11.

ABSTRACT

OBJECTIVE: To compare pericapsular nerve group block combined with lateral femoral cutaneous nerve block (PENG+LFCN) with fascia iliaca compartment block (FICB) for postoperative analgesia and functional recovery after hip surgery within Enhanced Recovery After Surgery (ERAS) pathways.

METHODS: PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and CQVIP were searched through January 2026. Comparative studies of PENG+LFCN versus FICB in hip surgery were included. Data were pooled using a random-effects model, with assessment of bias, heterogeneity, and publication bias.

RESULTS: Sixteen studies were included. The PENG+LFCN group had significantly lower resting VAS (MD = -0.54; p < 0.00001) and dynamic VAS (MD = -0.98; p < 0.00001) scores. It also showed a lower incidence of postoperative muscle weakness (OR = 0.10; p = 0.0001), better preservation of quadriceps muscle strength, shorter time to first ambulation (MD = -9.22 h; p < 0.0001), and reduced length of stay (MD = -0.75 days; p < 0.00001). Additionally, morphine consumption (MD = -24.22 mg; p = 0.001) and PCA pump activations (MD = -2.46; p < 0.00001) were lower in the PENG+LFCN group.

CONCLUSION: PENG+LFCN may be a more favorable regional analgesic strategy than FICB for hip surgery within ERAS pathways.

PROTOCOL REGISTRATION: This systematic review and meta-analysis was registered at PROSPERO https://www.crd.york.ac.uk/PROSPERO/view/CRD420261295309.

PMID:42109245 | DOI:10.1080/08941939.2026.2663595