Kukreja Promil, Schuster Braden, Northern Theresa, Sipe Sandra, Naranje Sameer, Kalagara Hari
Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, USA.
Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, USA.
Cureus. 2020 Dec 23;12(12):e12233. doi: 10.7759/cureus.12233.
Orthopedic procedures involving the hip have remained challenging for regional anesthesia given the complex innervation, painful nature contributing to difficulty positioning, and a desire to maintain mobility to hasten postoperative recovery. The revision total hip arthroplasty (THA) poses a greater challenge for an effective regional analgesia due to complex surgical approach, scarring from previous surgery and limited patient mobility. The quadratus lumborum (QL) block has demonstrated to provide effective analgesia for primary hip surgery in recent studies. The pericapsular nerve group (PENG) block has also shown to provide analgesia in patients with hip fractures. There is no standard of care regional anesthesia technique for hip surgeries, and the regional practice varies widely among anesthesia providers. This retrospective case series studied the effect of combining the QL with PENG block on the revision THA analgesia.
鉴于髋关节的神经支配复杂、疼痛性质导致体位摆放困难，以及为加速术后恢复而保持活动能力的需求，涉及髋关节的骨科手术对于区域麻醉来说一直具有挑战性。翻修全髋关节置换术（THA）由于手术入路复杂、既往手术留下的瘢痕以及患者活动受限，对有效的区域镇痛提出了更大的挑战。近期研究表明，腰方肌（QL）阻滞可为初次髋关节手术提供有效的镇痛效果。关节囊周围神经组（PENG）阻滞也已证明能为髋部骨折患者提供镇痛。目前尚无用于髋关节手术的区域麻醉技术的护理标准，麻醉提供者之间的区域麻醉实践差异很大。本回顾性病例系列研究了QL阻滞与PENG阻滞联合应用对翻修THA镇痛的效果。
