Berlioz Beric E., Bojaxhi Elird
Mayo Clinic
The pericapsular nerve group block (PENG) is a regional anesthetic technique described in 2018, developed primarily in total hip arthroplasties (THA) for postoperative analgesia with motor sparing benefits. The block is thought to provide more complete analgesia to the hip by depositing local anesthetic within the myofascial plane of the psoas muscle and superior pubic ramus.Furthermore, the blocking and understanding of the terminal nerves that innervate the hip joint have also been described in patients with chronic hip pain. The indications for THA often include degenerative hip disease and traumatic hip fractures. These indications for surgery are relatively common in the elderly population and are associated with significant morbidity and mortality. Operative intervention, such as THA, has also been associated with significant pain. Historically, the most commonly performed peripheral nerve blocks include lumbar plexus block, a femoral nerve block, or a fascia iliaca compartment block to manage post-operative analgesia. With the understanding that additional articular branches (i.e., from the sciatic nerve) these blocks will provide incomplete analgesia to the hip and may also predispose the patient to fall due to weakness of the quadriceps muscles. Therefore the ideal block technique should provide complete analgesia of the hip joint and without muscle weakness.
关节囊周围神经阻滞（PENG）是2018年描述的一种区域麻醉技术，主要用于全髋关节置换术（THA）以获得保留运动功能的术后镇痛效果。该阻滞被认为是通过在腰大肌和耻骨上支的肌筋膜平面内注射局部麻醉药，为髋关节提供更完全的镇痛。此外，在慢性髋关节疼痛患者中，也描述了对支配髋关节的终末神经的阻滞和认识。THA的适应证通常包括退行性髋关节疾病和创伤性髋关节骨折。这些手术适应证在老年人群中相对常见，并且与显著的发病率和死亡率相关。手术干预，如THA，也与显著的疼痛有关。从历史上看，最常用的周围神经阻滞包括腰丛阻滞、股神经阻滞或髂筋膜间隙阻滞，以管理术后镇痛。由于认识到这些阻滞（即来自坐骨神经的额外关节支）对髋关节的镇痛不完全，并且可能还会因股四头肌无力而使患者易跌倒。因此，理想的阻滞技术应能提供髋关节的完全镇痛且无肌肉无力。
