连续关节囊周围神经组阻滞用于全髋关节置换术后疼痛管理：两例报告
Continuous pericapsular nerve group block for postoperative pain management in total hip arthroplasty: report of two cases.
作者信息
Fujino Takashi, Odo Masahiko, Okada Hisako, Takahashi Shinji, Kikuchi Toshihiro
机构信息
Department of Anesthesiology and Pain Medicine, Juntendo Nerima University Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
Department of Anesthesiology and Pain Medicine, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu-shi, Chiba, 279-0021, Japan.
出版信息
JA Clin Rep. 2021 Mar 7;7(1):22. doi: 10.1186/s40981-021-00423-1.
BACKGROUND
Total hip arthroplasty (THA) is one of the surgical procedures associated with severe postoperative pain. Appropriate postoperative pain management is effective for promoting early ambulation and reducing the length of hospital stay. Effects of conventional pain management strategies, such as femoral nerve block and fascia iliaca block, are inadequate in some cases.
CASE PRESENTATION
THA was planned for 2 patients with osteoarthritis. In addition to general anesthesia, continuous pericapsular nerve group (PENG) block and lateral femoral cutaneous nerve (LFCN) block were performed for postoperative pain management. Numerical rating scale (NRS) scores measured at rest and upon movement were low at 2, 12, 24, and 48 h postoperatively, suggesting that the treatments were effective for managing postoperative pain. The Bromage score at postoperative days (POD) 1 and 2 was 0.
CONCLUSION
Continuous PENG block and LFCN block were effective for postoperative pain management in patients who underwent THA. PENG block did not cause postoperative motor blockade.
背景
全髋关节置换术（THA）是与严重术后疼痛相关的外科手术之一。适当的术后疼痛管理对于促进早期活动和缩短住院时间有效。在某些情况下，诸如股神经阻滞和髂筋膜阻滞等传统疼痛管理策略的效果并不充分。
病例介绍
计划对2例骨关节炎患者实施全髋关节置换术。除全身麻醉外，还进行了连续关节囊周围神经组（PENG）阻滞和股外侧皮神经（LFCN）阻滞用于术后疼痛管理。术后2、12、24和48小时静息和活动时测量的数字评定量表（NRS）评分较低，表明这些治疗对管理术后疼痛有效。术后第1天和第2天的布罗麻评分均为0。
结论
连续PENG阻滞和LFCN阻滞对于接受全髋关节置换术患者的术后疼痛管理有效。PENG阻滞未引起术后运动阻滞。
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