Efficacy of Ultrasound-Guided Pericapsular Nerve Group (PENG) Block Combined With Local Infiltration Analgesia on Postoperative Pain After Total Hip Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial

被引:11
|
作者
Hu, Jian [1 ,2 ]
Wang, Qiuru [3 ]
Hu, Jie [1 ,2 ]
Kang, Pengde [3 ,6 ]
Yang, Jing [1 ,2 ,4 ,5 ]
机构
[1] Sichuan Univ, West China Hosp, Dept Anesthesiol, Chengdu, Sichuan, Peoples R China
[2] Sichuan Univ, West China Hosp, Natl Clin Res Ctr Geriatr, Chengdu, Sichuan, Peoples R China
[3] Sichuan Univ, West China Hosp, Dept Orthoped Surg, Chengdu, Peoples R China
[4] West China Hosp Sichuan Univ, Dept Anesthesiol, Chengdu 610041, Sichuan, Peoples R China
[5] Sichuan Univ, West China Hosp, Natl Clin Res Ctr Geriatr, Chengdu 610041, Sichuan, Peoples R China
[6] Sichuan Univ, West China Hosp, Dept Orthoped, Chengdu, Sichuan, Peoples R China
来源
JOURNAL OF ARTHROPLASTY | 2023年 / 38卷 / 06期
关键词
total hip arthroplasty; pericapsular nerve group block; local infiltration analgesia; pain; enhanced recovery; KNEE ARTHROPLASTY; BUPIVACAINE; MANAGEMENT; RECOVERY; SURGERY;
D O I
10.1016/j.arth.2022.12.023
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: This study examined whether pericapsular nerve group (PENG) block combined with local infiltration analgesia (LIA) could improve pain management and functional recovery after total hip arthroplasty.Methods: All patients were randomly assigned to receive PENG block combined with LIA (PENG group) or sham PENG block and LIA (Sham group). The primary outcome was cumulative morphine consumption within 24 hours after surgery. Secondary outcomes were pain scores on a visual analog scale (VAS); time to first rescue analgesia; cumulative morphine consumption during hospitalization; intraoperative consumption of opioids; postoperative recovery; and postoperative complications.Results: PENG patients consumed significantly less morphine within the first 24 hours and throughout hospitalization and smaller amounts of intraoperative opioids. There were significantly lower pain scores at rest and during motion within 24 hours in PENG patients. PENG patients took significantly longer until the first rescue analgesia and showed significantly better postoperative rehabilitation. However, the absolute change in morphine consumption and VAS scores did not exceed the reported minimal clinically important differences (morphine consumption: 10 mg; VAS scores: 1.5 at rest and 1.8 during movement). The two groups showed no difference in quadriceps muscle strength and postoperative complications.Conclusion: PENG block combined with LIA could improve postoperative pain relief, reduce opioid use, and enhance recovery in total hip arthroplasty patients, without weakening the quadriceps muscle strength. This work justifies further trials to examine the safety and efficacy of this block and to explore maximal effective volume of local anesthetic for motor-sparing PENG block.(c) 2022 Elsevier Inc. All rights reserved.
引用
收藏
页码:1096 / 1103
页数:8
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