Pericapsular Nerve Group Block Versus Femoral Nerve Block Study

Hip fractures are common in older adults and are often associated with severe pain, making it difficult for patients to sit for spinal anesthesia before surgery. Peripheral nerve blocks may improve pain control and facilitate patient positioning, but it remains uncertain whether the Pericapsular Nerve Group (PENG) block provides advantages over the traditional femoral nerve block during the spinal anesthesia procedure.

Inclusion Criteria: * Adults aged 50 years or older. * Diagnosis of proximal femoral fracture. * Scheduled to undergo surgical repair under spinal anesthesia. * American Society of Anesthesiologists (ASA) physical status I-III. * Able to provide written informed consent. Exclusion Criteria: * Refusal to participate or inability to provide informed consent. * Coagulopathy or contraindication to spinal anesthesia or peripheral nerve block. * Local infection at the planned injection site. * Known allergy or hypersensitivity to local anesthetics. * Pre-existing neurological disease affecting lower extremity function or sensory assessment. * Cognitive impairment preventing reliable study participation or outcome assessment. * Previous lumbar spine surgery. * Polytrauma. * Body mass index (BMI) \40 kg/m². * Current anticoagulant therapy that precludes neuraxial anesthesia or peripheral nerve block according to institutional practice.