Minimum effective volume of the pericapsular nerve group (PENG) block in association with a standardized obturator nerve block for analgesia in hip osteoarthritis: An up-and-down study

2026-06-24

PRE

Pedro Hilton de Andrade Filho *

Rayane da Silva Souza Barbosa

Guilherme Pompei Tafner

Guilherme Anitele Silva

Maria Fernanda de Paula Ferreira

Henrique Melo de Campos Gurgel

Philip W.H. Peng

Hazem Adel Ashmawi

DOI：10.1016/j.jclinane.2026.112267

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Abstract

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• Combined PENG and ON block MEV was determined for hip osteoarthritis. • Theoretical MEV50 was 1.53 mL, but 3 mL served as the practical clinical floor. • Low-volume ensures analgesia while fully preserving functional mobility. • Fluoroscopy validated the anatomical injectate spread in all patients. • Findings provide a foundational proof-of-concept for neurolytic studies.

Keywords:

PENG block

Hip osteoarthritis

Minimum effective volume

Pain

Chronic pain

Minimum effective volume of the pericapsular nerve group (PENG) block in association with a standardized obturator nerve block for analgesia in hip osteoarthritis: An up-and-down study

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