Use of Dexamethasone via Two Methods in PENG Block for Patients Undergoing Femoral Fracture Surgery: A Prospective Observational Study

Abstract

Objectives: This study investigates the effectiveness of dexamethasone when utilized as an adjunct agent in enhancing the outcomes of a pericapsular nerve group (PENG) block compared to its systemic administration for managing pain in patients having surgery for femoral fractures. Methods: This study enrolled 44 patients who received a PENG block following spinal anesthesia. Two groups were formed by stratifying the patients, involving those in whom dexamethasone was received through perineural administration (Group P, n = 22) and those in whom it was received through systemic administration (Group S, n = 22). Information concerning the demographic features of the patients, along with operative and postoperative details, was meticulously documented for analysis. The patients’ pain levels were recorded using the numerical rating scale (NRS) at multiple time points. Results: In the perineural dexamethasone group, the length of time of sensory and motor blockade and the time elapsed until the initial analgesic requirement were longer (p < 0.001). The consumption of tramadol and the pain scores measured were noted to be decreased. (p < 0.001). There were no notable distinctions regarding patient mobilization or the length of inpatient stay. Conclusions: The perineural administration of dexamethasone in PENG block procedures may provide more effective analgesia for surgeries involving femoral neck fractures. By minimizing the use of systemic opioids, it may also help mitigate potential side effects. These findings indicate that perineural dexamethasone could serve as a beneficial adjuvant agent for patients undergoing femoral neck fracture surgeries. © 2025 by the authors.