<![CDATA[Background: Effective pain control after hip surgery is critical; however, conventional regional techniques often cause quadriceps motor blockade, delaying ambulation. The pericapsular nerve group (PENG) block offers a motor-sparing alternative. This study aimed to evaluate whether ropivacaine-based PENG blocks provide superior opioid-sparing and analgesic benefits compared with other ropivacaine-based regional techniques in adults undergoing hip surgery. Methods: This systematic review and meta-analysis sampled randomized controlled trials (RCTs) published between 2015 and 2025 from PubMed, the Cochrane Library, and ScienceDirect. Included studies compared ropivacaine PENG blocks against active regional comparators in adults (≥18 years) undergoing hip surgery. Evidence quality was assessed using the Cochrane Risk of Bias tool. Statistical analysis was performed via quantitative synthesis to calculate mean differences (MD) with 95% confidence intervals (CI) for outcome measures. Results: From 15 included RCTs encompassing 886 patients, quantitative synthesis demonstrated that PENG blocks significantly reduced 24-hour opioid consumption (MD −3.61 morphine milligram equivalents; 95% CI −5.71 to −1.50) and 24-hour pain intensity (MD −1.11; 95% CI −1.30 to −0.92). Time to first ambulation generally favor the PENG group. Opioid- and block-related adverse events were comparable across groups. Conclusion: In adults undergoing hip surgery, PENG blocks provide statistically significant reductions in early postoperative pain and opioid consumption without compromising safety, supporting their use in motor-sparing multimodal analgesic pathways.]]>
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