Hamra Pedro, Sau André Sanches, Junior Walter Ricioli, Rabelo Nayra Deise Dos Anjos, Polesello Giancarlo Cavalli
Médico, Especialista em Cirurgia do Quadril, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brasil.
Instrutor de Ensino Médico e Assistente de Grupo de Quadril, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2023 Aug 30;58(4):e646-e652. doi: 10.1055/s-0042-1758367. eCollection 2023 Aug.
To evaluate the technical reproducibility of a block of the pericapsular nerve group (PENG) of the hip aided or not by ultrasound in cadavers. The present is a randomized, descriptive, and comparative anatomical study on 40 hips from 2 cadaver groups. We compared the PENG block technique with the method with no ultrasound guidance. After injecting a methylene blue dye, we verified the dispersion and topographical staining of the anterior hip capsule through dissection. In addition, we evaluated the injection orifice in both techniques. In the comparative analysis of the techniques, there were no puncture failures, damage to noble structures in the orifice path, or differences in the results. Only 1 hip from each group (5%) presented inadequate dye dispersion within the anterior capsule, and in 95% of the cases submitted to either technique, there was adequate dye dispersion at the target region. Hip PENG block with no ultrasound guidance is feasible, safe, effective, and highly reliable compared to its conventional counterpart. The present is a pioneer study that can help patients with hip pain from various causes in need of relief.
评估在尸体中,超声辅助或不辅助下的髋关节囊周神经组(PENG)阻滞的技术可重复性。
本研究是一项对来自2组尸体的40个髋关节进行的随机、描述性和对比性解剖学研究。我们将PENG阻滞技术与无超声引导的方法进行了比较。注射亚甲蓝染料后,我们通过解剖验证了髋关节前囊的染料扩散和局部染色情况。此外,我们评估了两种技术的注射孔。
在技术的对比分析中,没有穿刺失败、注射孔路径中重要结构的损伤或结果差异。每组仅1个髋关节(5%)在前囊内染料扩散不充分,在采用任一技术的病例中,95%在目标区域染料扩散充分。
与传统的髋关节PENG阻滞相比,无超声引导的髋关节PENG阻滞是可行、安全、有效且高度可靠的。本研究是一项开创性研究,可为因各种原因导致髋关节疼痛需要缓解的患者提供帮助。