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用于髋关节镜手术围手术期疼痛管理的关节囊周围神经组阻滞

The Pericapsular Nerve Group Block for Perioperative Pain Management for Hip Arthroscopy.

作者信息

Jacob Tannehill I, Tucker Christopher J, Robert Volk W, Dickens Jonathan F

机构信息

Department of Orthopaedic Surgery Walter Reed National Military Medical Center, Bethesda, Maryland.

Department of Anesthesiology, Kimbrough Ambulatory Care Center, Fort Meade, Maryland, U.S.A.

出版信息

Arthrosc Tech. 2021 Jul 22;10(7):e1799-e1803. doi: 10.1016/j.eats.2021.03.029. eCollection 2021 Jul.


DOI:10.1016/j.eats.2021.03.029
PMID:34336578
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8322623/
Abstract

Perioperative pain control for hip arthroscopy procedures represents a significant challenge for both surgeons and anesthetists. In light of the opioid crisis, greater emphasis has been placed on multimodal pain control techniques. There is considerable debate regarding regional nerve blockade for hip arthroscopy. Although regional anesthesia has a significant role in perioperative pain management strategies, many of the most common techniques present their own risks and limitations. In particular, the less desirable effects of postoperative weakness in the lower extremity and difficulty with ambulation are commonly produced with standard regional blockades. We present a technique for performing a targeted, sensory nerve block that can be done efficiently and safely in the immediate preoperative period. This block can potentially lower the intraoperative and postoperative opioid requirements without the risks of muscle blockade and falls from other regional anesthesia modalities.

摘要

髋关节镜手术的围手术期疼痛控制对外科医生和麻醉师来说都是一项重大挑战。鉴于阿片类药物危机,人们更加重视多模式疼痛控制技术。关于髋关节镜手术的区域神经阻滞存在相当多的争论。尽管区域麻醉在围手术期疼痛管理策略中发挥着重要作用,但许多最常用的技术都有其自身的风险和局限性。特别是,标准区域阻滞通常会导致下肢术后无力和行走困难等不良后果。我们介绍一种在术前即刻能够高效、安全地进行的靶向感觉神经阻滞技术。这种阻滞有可能降低术中及术后对阿片类药物的需求,且没有肌肉阻滞和其他区域麻醉方式导致跌倒的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/9c080fe267f1/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/5b1d25ba1431/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/c1029378db4e/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/f9a5dbb596b1/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/9c080fe267f1/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/5b1d25ba1431/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/c1029378db4e/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/f9a5dbb596b1/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/9c080fe267f1/gr4.jpg

相似文献

[1]
The Pericapsular Nerve Group Block for Perioperative Pain Management for Hip Arthroscopy.

Arthrosc Tech. 2021-7-22

[2]
Preoperative Femoral Nerve Block for Hip Arthroscopy: A Randomized, Triple-Masked Controlled Trial.

Am J Sports Med. 2015-11

[3]
Pain Management After Hip Arthroscopy: Systematic Review of Randomized Controlled Trials and Cohort Studies.

Am J Sports Med. 2017-10-13

[4]
Preoperative Fascia Iliaca Block Does Not Improve Analgesia after Arthroscopic Hip Surgery, but Causes Quadriceps Muscles Weakness: A Randomized, Double-blind Trial.

Anesthesiology. 2018-9

[5]
The Effect of Intra-articular Cocktail Versus Femoral Nerve Block for Patients Undergoing Hip Arthroscopy.

Arthroscopy. 2017-8-31

[6]
Preoperative femoral nerve block in hip arthroscopic surgery: a retrospective review of 108 consecutive cases.

Am J Sports Med. 2013-11-27

[7]
Psychological distress in hip arthroscopy patients affects postoperative pain control.

Arthroscopy. 2014-2

[8]
A pre-emptive multimodal pathway featuring peripheral nerve block improves perioperative outcomes after major orthopedic surgery.

Reg Anesth Pain Med. 2008

[9]
Lower-extremity peripheral nerve blocks in the perioperative pain management of orthopaedic patients: AAOS exhibit selection.

J Bone Joint Surg Am. 2012-11-21

[10]
Postoperative Pain Management Strategies in Hip Arthroscopy.

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引用本文的文献

[1]
Clinical outcomes of pericapsular nerve group block in hip arthroscopy: A systematic review and meta-analysis.

J Exp Orthop. 2025-7-24

[2]
Does Ischemic Preconditioning of the Operative Limb Reduce Pain After Hip Arthroscopy? A Prospective, Single-Blind, Randomized Controlled Trial.

Orthop J Sports Med. 2025-6-10

[3]
Declining Postoperative 90-Day Opioid Prescriptions From 2010 to 2021 Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Arthrosc Sports Med Rehabil. 2025-1-16

[4]
Pericapsular nerve group block and lateral femoral cutaneous nerve block versus fascia iliaca block for multimodal analgesia after total hip replacement surgery: A retrospective analysis.

Saudi J Anaesth. 2024

[5]
The Addition of a Pericapsular Nerve Group Block for Postoperative Pain Control Does Not Result in Less Narcotic Use After Hip Arthroscopy: A Systematic Review.

Arthrosc Sports Med Rehabil. 2024-2-15

[6]
Addition of Pericapsular Nerve Group and Transversus Abdominis Plane Blocks Significantly Reduces Opioid Use in Patients Undergoing Concomitant Hip Arthroscopy and Periacetabular Osteotomy.

Cureus. 2023-1-2

[7]
Efficacy of pericapsular nerve group (PENG) block on perioperative pain management in elderly patients undergoing hip surgical procedures: a protocol for a systematic review with meta-analysis and trial sequential analysis.

BMJ Open. 2023-1-5

[8]
Preoperative Pericapsular Nerve Group Block Results in Less Pain, Decreased Narcotic Use, and Quicker Discharge Time Than No Block in Patients Who Were Surgically Treated for Femoroacetabular Impingement Syndrome.

Arthrosc Sports Med Rehabil. 2022-8-2

本文引用的文献

[1]
A Shift in Hip Arthroscopy Use by Patient Age and Surgeon Volume: A New York State-Based Population Analysis 2004 to 2016.

Arthroscopy. 2019-10

[2]
Fascia Iliaca Blockade With the Addition of Liposomal Bupivacaine Versus Plain Bupivacaine for Perioperative Pain Management During Hip Arthroscopy: A Double-Blinded Prospective Randomized Control Trial.

Arthroscopy. 2019-8-8

[3]
Pericapsular Nerve Group (PENG) Block for Hip Fracture.

Reg Anesth Pain Med. 2018-11

[4]
Single-dose lidocaine spinal anesthesia in hip and knee arthroplasty.

Arthroplast Today. 2018-3-28

[5]
Anatomic Study of Innervation of the Anterior Hip Capsule: Implication for Image-Guided Intervention.

Reg Anesth Pain Med. 2018-2

[6]
A Prospective Randomized Controlled Trial Comparing the Efficacy of Fascia Iliaca Compartment Block Versus Local Anesthetic Infiltration After Hip Arthroscopic Surgery.

Arthroscopy. 2017-1

[7]
Anesthesia for hip arthroscopy: a narrative review.

Can J Anaesth. 2016-11

[8]
Ambulatory continuous posterior lumbar plexus blocks following hip arthroscopy: a review of 213 cases.

J Clin Anesth. 2013-5-9

[9]
Characterisation and classification of the neural anatomy in the human hip joint.

Hip Int. 2012

[10]
The innervation of the hip joint.

Anat Rec. 1948-7

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