PENG Block Nerve Targets
The PENG (Pericapsular Nerve Group) block targets the sensory branches of the femoral nerve, obturator nerve, and accessory obturator nerve that innervate the anterior hip joint capsule. 1
Anatomical Targets
The PENG block specifically aims to anesthetize:
- Femoral nerve sensory branches - These provide innervation to the anterior hip capsule 1
- Obturator nerve sensory branches - These contribute to hip joint capsule sensation 1
- Accessory obturator nerve (when present) - This nerve also supplies the anterior capsule 1
Key Characteristics of the Block
The PENG block is designed as a motor-sparing technique that preserves quadriceps function while providing hip analgesia. 2 This distinguishes it from other regional techniques like fascia iliaca blocks that may cause more motor weakness.
Clinical Evidence
The block was first described in 2018 and has since accumulated substantial evidence, with over 50 publications by 2021. 1 The technique specifically targets the anterior hip capsule innervation rather than attempting to block the entire nerve distributions, which explains its motor-sparing properties. 2
What the PENG Block Does NOT Target
The PENG block does not provide complete anesthesia for hip surgery, as it spares:
- Motor branches of the femoral nerve (preserving quadriceps strength) 2
- Posterior hip capsule innervation 3
- Lateral femoral cutaneous nerve distribution (often requiring a separate block for complete coverage) 3
This selective sensory blockade of the anterior hip capsule nerves makes the PENG block particularly suitable for enhanced recovery protocols where early mobilization is prioritized. 2