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All Journal Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
I Gusti Agung Gede Utara Hartawan
Udayana University
Health Professions Medicine & Pharmacology Physics

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Ultrasound-Guided PENG Block for Analgesia in Early Pregnancy with Femoral Head Fracture and Hip Dislocation: A Case Report Made Agus Cahya Nugraha Koriawan; I Gusti Agung Gede Utara Hartawan
Jurnal Anestesiologi dan Terapi Intensif Vol. 2 No. 1 (2026): JATI APRIL
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/3eb6hh34

Abstract

Femoral head fracture accompanied by hip dislocation during pregnancy is an uncommon clinical event that presents significant challenges in maternal analgesia and fetal safety. Traumatic hip dislocations account for a small proportion of joint dislocations, while their occurrence during pregnancy is rarely reported, particularly when associated with femoral head fractures. Management becomes more complex because timely reduction and defenitive orthopedic fixation must be achieved while ensuring adequate analgesia and minimizing systemic drug exposure. We describe the case of a 32-year-old woman in early pregnancy (11 weeks of gestation) who presented with a posterior dislocation of the left hip accompanied by a Pipkin type I femoral head fracture following a traffic accident. To provide effective analgesia and reduce fetal risk, a pericapsular nerve group (PENG) block was selected as part of the anesthetic strategy. This regional technique enabled optimal positioning for reduction, minimized the requirement for systemic opioids, and supported early mobilization. Maternal hemodynamics and fetal parameters remained stable throughout the perioperative period. This case highlights the potential role of the PENG block as a focused regional analgesic technique in pregnant trauma patients, particularly during early gestation, where minimizing systemic drug exposure is a critical priority.
Ultrasound-Guided PENG Block for Analgesia in Early Pregnancy with Femoral Head Fracture and Hip Dislocation: A Case Report Made Agus Cahya Nugraha Koriawan; I Gusti Agung Gede Utara Hartawan
Jurnal Anestesiologi dan Terapi Intensif Vol. 2 No. 1 (2026): JATI APRIL
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/3eb6hh34

Abstract

Femoral head fracture accompanied by hip dislocation during pregnancy is an uncommon clinical event that presents significant challenges in maternal analgesia and fetal safety. Traumatic hip dislocations account for a small proportion of joint dislocations, while their occurrence during pregnancy is rarely reported, particularly when associated with femoral head fractures. Management becomes more complex because timely reduction and defenitive orthopedic fixation must be achieved while ensuring adequate analgesia and minimizing systemic drug exposure. We describe the case of a 32-year-old woman in early pregnancy (11 weeks of gestation) who presented with a posterior dislocation of the left hip accompanied by a Pipkin type I femoral head fracture following a traffic accident. To provide effective analgesia and reduce fetal risk, a pericapsular nerve group (PENG) block was selected as part of the anesthetic strategy. This regional technique enabled optimal positioning for reduction, minimized the requirement for systemic opioids, and supported early mobilization. Maternal hemodynamics and fetal parameters remained stable throughout the perioperative period. This case highlights the potential role of the PENG block as a focused regional analgesic technique in pregnant trauma patients, particularly during early gestation, where minimizing systemic drug exposure is a critical priority.
Co-Authors Made Agus Cahya Nugraha Koriawan