Results
NRS
COMPLICATIONS
One hundred and sixty two patients were assessed for eligibility. Following the exclusion of 78 patients, a total of 84 patients were randomized into two groups. The CONSORT Flow diagram is shown in Fig. 
Comparison of demographic data and first opioid requirement between groups. Surgery types are expressed as number of patients whereas other data is expressed as mean ± standard deviationType of Surgery(Hip hemiarthroplasty / Proximal femoral nailing)The demographic characteristics of participants are demonstrated in Table Preoperative NRS scores were similar between two groups (p = 0.0885). As the primary outcome of the study; patients that underwent PENG had statistically significantly lower NRS scores after interventions, immediately before positioning, at positioning and at end of spinal anesthesia (p < 0.0001, p < 0.0001 and, p < 0.0001, respectively). Additionally, the anesthesiologist evaluated the quality of the patient’s position, and it was statistically significantly higher in the PENG group when compared to the control group (p < 0.0001) (Table 
Comparison of peri-positioning NRS scales, quality of patient’s position. Data are expressed as median (percentiles 25–75)Table 
NRS scores, total morphine consumption, time to first PCA use and QoR 15 scores for groups. Data are expressed as median (percentiles 25–75)Requirement of first analgesia was later in the PENG group (9.12 ± 3.61 h vs. 5.07 ± 2.55 h, p < 0.001). NRS scores were significantly lower at 3rd, 6th and 12th hours in the PENG group, but similar at other times. According to the QoR 15 scores, which is a questionnaire used to measure the quality of recovery in patients, the PENG group demonstrated significantly better recovery quality compared to the control group (111.02 ± 9.67 vs. 99.51 ± 9.45, respectively, p < 0.001).There were no complications that we detected or reported afterwards, either in the application of PENG block or in the application of spinal anesthesia.
Demonstration of cumulative morphine requirements between groups at different times