Department of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Orthopedic Surgery, Montefiore Medical Center and The Albert Einstein College of MedicineBronx, NY, USA.
Hip Int. 2022 Mar;32(2):265-270. doi: 10.1177/1120700020950247. Epub 2020 Aug 31.
Literature addressing postoperative pain management after hip arthroscopy is relatively scarce. This study aimed to assess if there was added analgesic benefit associated with postoperative intra-articular bupivacaine blockade for patients who received preoperative peri-acetabular blockade for hip arthroscopy procedures.
52 patients were included in this comparative cohort study. Group 1 consisted of 20 patients who received preoperative peri-acetabular blockade and postoperative intra-articular blockade. The control group (Group 2), consisted of 32 patients who received only preoperative peri-acetabular blockade. Postoperative pain was recorded via visual analogue scale (VAS) pain scores, analgesic consumption, and pain diaries for 2 weeks postoperatively.
Postoperative VAS pain scores were significantly lower in the experimental group at the 30-minute recovery room assessment (VAS scores Group 1: 1.1; Group 2: 3.00, = 0.034). Other than the 30-minute recovery room assessment, VAS pain scores, narcotic medication consumption, and non-narcotic analgesic consumption did not differ between the 2 groups at any time point in the study period.
This study did not demonstrate significant clinical benefit for patients who receive postoperative intra-articular blockade in addition to preoperative peri-acetabular blockade with bupivacaine 0.5%. We recommend the use of preoperative peri-acetabular bupivacaine blockade without intra-articular blockade postoperatively for pain control in the setting of hip arthroscopy surgery.
髋关节镜术后疼痛管理的文献相对较少。本研究旨在评估髋关节镜手术患者接受术前髋臼周围阻滞（peri-acetabular blockade）后，是否有额外的镇痛益处与关节内布比卡因阻滞相关。
本研究纳入了 52 名患者进行比较队列研究。第 1 组（Group 1）由 20 名接受术前髋臼周围阻滞和术后关节内阻滞的患者组成。对照组（Group 2）由 32 名仅接受术前髋臼周围阻滞的患者组成。术后疼痛通过视觉模拟评分（VAS）疼痛评分、镇痛药物消耗和术后 2 周的疼痛日记进行记录。
在术后 30 分钟的恢复室评估时，实验组的术后 VAS 疼痛评分明显更低（VAS 评分 Group 1：1.1；Group 2：3.00， = 0.034）。除了 30 分钟的恢复室评估外，在研究期间的任何时间点，两组的 VAS 疼痛评分、阿片类药物消耗和非阿片类镇痛药消耗均无差异。
本研究并未显示髋关节镜手术后接受关节内布比卡因阻滞（0.5%）的患者具有显著的临床获益。我们建议在髋关节镜手术中使用术前髋臼周围布比卡因阻滞，而不进行术后关节内阻滞，以控制疼痛。
