Department of Anesthesiology, The Second Affiliated Hospital of Xuzhou Medical University, No. 32, Meijian Road, Xuzhou, Jiangsu Province, China.
Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huai Hai West Road, Xuzhou, Jiangsu Province, China.
BMC Anesthesiol. 2023 Nov 23;23(1):383. doi: 10.1186/s12871-023-02336-1.
The aim of this study was to compare the efficacy of ultrasound-guided PENG (pericapsular nerve group) block and drug therapy with intravenous flurbiprofen for early analgesia in elderly patients with hip fractures after hospitalization.
This is a single-center, observer-blinded, prospective, randomized, controlled trial. A total of 41 elderly patients (aged 60 or older) with hip fractures were enrolled in the current study. Patients were randomly assigned to two groups: Group P (ultrasound-guided PENG block, 20 mL of 0.375% ropivacaine) and Group F (intravenous flurbiprofen 50 mg). The primary outcome measure was the dynamic (passive straight leg raising 15°) NRS (numerical rating scale 0 to 10) pain scores at different time points. The secondary outcomes were the static NRS scores at different time points, the number of rescue analgesia sessions, patient satisfaction, and the incidence of complications.
Patients in the two groups had comparable baseline characteristics. The group P had lower dynamic and static NRS scores at 15 min, 30 min, 6 h, and 12 h after intervention (P<0.05) than the group F. The highest NRS pain scores in the group P were still lower than the NRS scores in the group F at 30 min-12 h (Group F: 5.57±1.54 vs. Group P: 3.00±1.12, P<0.001), and there was no significant difference between the two groups at 12-24 h (Group F: 6.35±1.79 vs. Group P: 5.90±1.83, P>0.05). The group P had higher satisfaction scores (Group P: 9 (9,9) vs. Group F: 8 (7,8), P<0.001). There was no statistically significant difference in the number of rescue analgesics at 0-12 h or 12-24 h or the incidence of complications between the groups.
Compared with intravenous flurbiprofen, ultrasound-guided PENG block provides better early analgesic effects in elderly patients with hip fractures, and a PENG block is safe for elderly patients with hip fractures after hospitalization. Trial registration This study was registered in the Chinese Clinical Trial Testing Center (ID: ChiCTR2200062400).
本研究旨在比较超声引导下 PENG（囊周神经群）阻滞与静脉注射氟比洛芬酯在老年髋部骨折患者住院后早期镇痛的疗效。
这是一项单中心、观察者盲法、前瞻性、随机、对照试验。共纳入 41 例老年髋部骨折患者（年龄≥60 岁）。将患者随机分为两组：P 组（超声引导下 PENG 阻滞，0.375%罗哌卡因 20 mL）和 F 组（静脉注射氟比洛芬酯 50 mg）。主要结局测量指标为不同时间点的动态（被动直腿抬高 15°）NRS（数字评分量表 0-10）疼痛评分。次要结局包括不同时间点的静态 NRS 评分、补救镇痛次数、患者满意度和并发症发生率。
两组患者的基线特征具有可比性。干预后 15 min、30 min、6 h 和 12 h，P 组的动态和静态 NRS 评分均低于 F 组（P<0.05）。P 组的最高 NRS 疼痛评分在 30 min-12 h 仍低于 F 组（F 组：5.57±1.54 vs. P 组：3.00±1.12，P<0.001），而 12-24 h 两组间无显著差异（F 组：6.35±1.79 vs. P 组：5.90±1.83，P>0.05）。P 组的满意度评分更高（P 组：9（9，9）vs. F 组：8（7，8），P<0.001）。0-12 h 和 12-24 h 时补救镇痛次数或并发症发生率两组间无统计学差异。
与静脉注射氟比洛芬酯相比，超声引导下 PENG 阻滞可为老年髋部骨折患者提供更好的早期镇痛效果，且 PENG 阻滞对老年髋部骨折患者是安全的。
本研究在中国临床试验注册中心注册（ID：ChiCTR2200062400）。
