Smits Rachel J H, Tillmans Laura C M, Moll Anne C, Vissers Kris C P, van der Wal Selina E I
Radboudumc, afd. Anesthesiologie, Pijn- en Palliatieve Geneeskunde, Nijmegen.
Contact: Rachel J.H. Smits (
Ned Tijdschr Geneeskd. 2022 Aug 9;166:D6662.
Annually an estimated amount of 17.500 patients are admitted at the hospital with a fractured hip in the Netherlands. This often fragile population experiences many unwanted side effects with the use of strong painkillers. Currently used locoregional anesthetic techniques do not fully block pain in most hip fractures. In 2018 a novel technique was published, based on the innervation of the anterior hip capsule: 'The PEricapsular Nerve Group (PENG) block'. Based on current evidence, the PENG block seems a promising pain reducing technique in acute pain in pericapsular hip fractures and surgery. Due to the possibility of chemical denervation of the hip capsule, current literature and our own data show that long-term pain reduction is possible as well, without motor loss. This can lead to an increase of quality of life, and reduction of morbidity and mortality in the most fragile patients, who are not eligible for surgery.
在荷兰,每年估计有17500名髋部骨折患者入院。这群通常较为脆弱的人群在使用强效止痛药时会出现许多不良副作用。目前使用的局部麻醉技术在大多数髋部骨折中并不能完全阻断疼痛。2018年,一种基于髋关节前囊神经支配的新技术被发表:“髋关节囊周围神经群(PENG)阻滞”。基于目前的证据,PENG阻滞似乎是一种在髋关节囊周围髋部骨折和手术的急性疼痛中很有前景的减轻疼痛技术。由于髋关节囊化学去神经支配的可能性,目前的文献和我们自己的数据表明,长期减轻疼痛也是可能的,且不会导致运动功能丧失。这可以提高最脆弱患者(那些不符合手术条件的患者)的生活质量,并降低发病率和死亡率。