Martínez Martín A, Pérez Herrero M, Sánchez Quirós B, López Herrero R, Ruiz Bueno P, Cocho Crespo S
Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Valladolid, Valladolid, España.
Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Valladolid, Valladolid, España.
Rev Esp Cir Ortop Traumatol. 2023 Jan-Feb;67(1):27-34. doi: 10.1016/j.recot.2022.03.007. Epub 2022 Apr 26.
Hip fracture is a frequent orthopedic emergency which associates high morbidity and mortality and intense pain. Locoregional analgo-anesthetic techniques, both central and peripheral, occupy a preferential place in the multimodal therapeutic arsenal. Recently, a new regional blockade has emerged, the pericapsular block or PENG block (PEricapsular Nerve Group). The objective is to evaluate in patients with hip fracture, the antinociceptive efficacy of the preoperative PENG block, residual motor block and time for postoperative functional recovery.
Prospective descriptive observational study with patients going to have total hip arthroplasty. PENG block was performed before surgery. Pain was assessed with the Visual Numerical Scale (VNS) before the blockade, 30min later, in the immediate postoperative period and 24h after the intervention. Motor block according to the Bromage scale and time needed for assisted walking were also evaluated.
PENG block provided effective analgesia in all patients, with a decrease in at least 3 points on the VNS at every step in which it was evaluated. The average difference between pain before and after the block was 7.5 points on the VNS. It allowed the transfer and placement of the patient without hemodynamic alteration, exacerbation of pain or other complications.
PENG block is an effective and safe regional analgesic technique for patients with hip fracture. It allows mobilization and placement before surgery without pain exacerbation, promoting early mobility and rehabilitation.
髋部骨折是一种常见的骨科急症,常伴有高发病率、高死亡率以及剧痛。局部肛门麻醉技术,包括中枢和外周技术,在多模式治疗手段中占据优先地位。最近,一种新的区域阻滞方法出现了,即关节囊周围阻滞或PENG阻滞(关节囊周围神经组阻滞)。目的是评估髋部骨折患者术前PENG阻滞的镇痛效果、残余运动阻滞以及术后功能恢复时间。
对拟行全髋关节置换术的患者进行前瞻性描述性观察研究。在手术前进行PENG阻滞。在阻滞前、30分钟后、术后即刻以及干预后24小时,使用视觉数字评分法(VNS)评估疼痛。还评估了根据Bromage量表的运动阻滞情况以及辅助行走所需时间。
PENG阻滞在所有患者中均提供了有效的镇痛效果,在每次评估时VNS评分至少降低3分。阻滞前后疼痛的平均差异在VNS上为7.5分。它允许在不引起血流动力学改变、疼痛加剧或其他并发症的情况下转运和安置患者。
PENG阻滞对于髋部骨折患者是一种有效且安全的区域镇痛技术。它允许在手术前进行活动和安置而不加剧疼痛,促进早期活动和康复。