Pericapsular Nerve Group Block and Multimodal Analgesia in Shoulder Arthroscopy: A Review of Current Evidence

Abstract

Background: Shoulder arthroscopy is the second most common minimally invasive orthopedic procedure that involves the insertion of a small camera and instruments through tiny incisions in the shoulder joint. Postoperative pain in the first 24 hours after shoulder arthroscopy is commonly intense as the effects of anesthesia and nerve blocks wear off. The pain is often sharp, aching, or throbbing, especially with any movement of the shoulder, which leads to substantial utilization of opioids or nonsteroidal anti-inflammatory drugs resulting in prolonged recovery periods, and an elevated susceptibility to bleeding at the surgical site.

Aim: The aim of this review is to discuss the role of Pericapsular Nerve Group block versus multimodal analgesia in postoperative pain relief and quality of recovery after shoulder arthroscopy.

 Conclusion: The shoulder PENG block aims to target the articular branches through a single, ultrasound-guided injection into the fascial plane between the deltoid muscle and the subscapularis tendon in the region of the coracoid process. By depositing local anesthetic in this anatomical location, the block produces selective analgesia of the shoulder without affecting the more proximal origins of the brachial plexus. Therefore, PENG block may represent an important technique for postoperative pain relief and quality of recovery after shoulder arthroscopy.