Mostafa Tarek Abdel Hay, Mourad Mona Blough El, Mohamed Naglaa Khalil
Lecturer of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Assistant Professor of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt. ORCID: https://orcid.org/0000-0002-5049-8527.
J Opioid Manag. 2023 Jul-Aug;19(4):313-320. doi: 10.5055/jom.2023.0788.
This study aimed to evaluate the analgesic effect of the ultrasound-guided pericapsular nerve group (PENG) block in hip arthroplasty (HA) surgery.
A prospective double-blinded, randomized study.
Tertiary institutional clinical care.
Fifty patients, more than 50 years old of both genders, were chosen according to the American Society of Anesthesiologists classification, with physical status I-III, and scheduled for unilateral HA surgeries.
Patients were randomized to receive either a sham PENG block with 20 mL of normal saline (control group) or a PENG block with 20 mL of bupivacaine 0.25 percent (PENG group).
From the onset of the first request for rescue opioid analgesia, preoperative pain scores before and after block (at rest and with a raised straight leg), the incidence of quadriceps weakness after the block, intraoperative fentanyl consumption, post-operative pain scores, and morphine consumption, besides the presence and frequency of adverse events, were recorded.
The patients undergoing PENG block with bupivacaine had prolonged durations before the first analgesic request, lower perioperative pain scores, less intraoperative rescue fentanyl, and less post-operative morphine consumption than the control group, with nonsignificant motor weakness after the block and similar adverse events.
The PENG block provided effective perioperative analgesia for HA with prolonged duration of analgesia, nonsignificant motor effects, reduced perioperative opioids consumption, and no major side effects.
本研究旨在评估超声引导下髋关节囊周围神经组(PENG)阻滞在髋关节置换术(HA)中的镇痛效果。
一项前瞻性双盲随机研究。
三级医疗机构临床护理。
根据美国麻醉医师协会分类,选择50名年龄超过50岁的男女患者,身体状况为I-III级,计划进行单侧HA手术。
患者被随机分为两组,一组接受20毫升生理盐水的假性PENG阻滞(对照组),另一组接受20毫升0.25%布比卡因的PENG阻滞(PENG组)。
记录从首次请求使用急救阿片类镇痛药开始,阻滞前后(静息时和直腿抬高时)的术前疼痛评分、阻滞后股四头肌无力的发生率、术中芬太尼用量、术后疼痛评分和吗啡用量,以及不良事件的发生情况和频率。
与对照组相比,接受布比卡因PENG阻滞的患者首次镇痛请求前的时间延长、围手术期疼痛评分更低、术中急救芬太尼更少、术后吗啡用量更少,阻滞后运动无力不显著,不良事件相似。
PENG阻滞为HA提供了有效的围手术期镇痛,镇痛时间延长,运动影响不显著,围手术期阿片类药物用量减少,且无重大副作用。