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A response to Rashomon perspectives in PENG block

rapm · 2026-05-05 · canonical JSON source

2 visible annotations · policy: published · automated confidence ≥ 75.00%

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We thank Girón-Arango et al for their elaborate discussion of our recent publication.1 2 We would like to respond to their comments and provide further clarification on the points raised. We disagree with Girón-Arango et al’s comments regarding the ‘Rashomon effect’. Conflicting interpretations and outcomes in the study of fascial plane blocks are commonplace, unlike the more predictable outcomes of traditional nerve blocks. In our study, Pericapsular Nerve Group (PENG) blocks were performed according to the original description.3 Previous cadaveric studies of the PENG block, including those by Leurcharusmee et al 4 and Kim et al,5 have also demonstrated that injectate often fails to reach the intended fascial planes, instead spreading into adjacent muscle layers or intramuscularly, sometimes leading to inadvertent femoral nerve involvement. Furthermore, clinical reports of quadriceps weakness after PENG blocks in patients suggest that local anesthetic spread can extend beyond the intended PENG.6–8