Department of Anesthesiology, Affiliated Hospital of Chengde Medical University, Chengde 067000, China.
Int J Clin Pract. 2024 Mar 13;2024:6896066. doi: 10.1155/2024/6896066. eCollection 2024.
To evaluate the effectiveness and safety of pericapsular nerve group (PENG) block for hip fracture surgery under spinal anesthesia.
This meta-analysis was registered on INPLASY (INPLASY202270005). PubMed, Embase, Cochrane, CNKI, and Wanfang databases were searched to collect the randomized controlled trials of the PENG block applied to hip fracture surgery in the setting of spinal anesthesia, with the search period from inception to 1 May 2023. Two independent researchers gradually screened the literature, evaluated the quality, extracted the data, and eventually pooled data using RevMan 5.4.
Fifteen articles with 890 patients were enrolled. The combined results showed that the PENG block reduced pain scores during position placement (SMD = -0.35; 95% CI [-0.67, 0.02]; =0.04; = 0%). Subgroup analyses showed that compared to the unblocked group, the PENG block reduced pain scores at 12 h, 24 h, and 48 h postoperatively. The incidence of postoperative hypokinesia was reduced (RR = 0.11; 95% CI [0.01, 0.86]; =0.04; = 0.00%). The time to first walking was advanced (SMD = -0.90; 95% CI [-1.17, 0.63]; < 0.00001; = 0%).
The PENG block can reduce postoperative pain and pain during spinal anesthesia positioning, which is helpful to improve the operability and comfort of spinal anesthesia and facilitate postoperative muscle strength recovery and early activity.
评估脊柱麻醉下囊周神经群（PENG）阻滞在髋部骨折手术中的有效性和安全性。
本 meta 分析已在 INPLASY（INPLASY202270005）上注册。检索 PubMed、Embase、Cochrane、CNKI 和万方数据库，以收集 PENG 阻滞应用于脊柱麻醉下髋部骨折手术的随机对照试验，检索时间从建库至 2023 年 5 月 1 日。两名独立的研究人员逐步筛选文献，评估质量，提取数据，并最终使用 RevMan 5.4 汇总数据。
纳入了 15 项包含 890 名患者的研究。合并结果显示，PENG 阻滞降低了体位摆放时的疼痛评分（SMD=-0.35；95%CI[-0.67, 0.02]；=0.04；=0.00）。亚组分析显示，与未阻滞组相比，PENG 阻滞降低了术后 12、24 和 48 小时的疼痛评分。术后运动障碍的发生率降低（RR=0.11；95%CI[0.01, 0.86]；=0.04；=0.00）。首次行走时间提前（SMD=-0.90；95%CI[-1.17, 0.63]；<0.00001；=0.00）。
PENG 阻滞可减轻术后疼痛和脊柱麻醉定位时的疼痛，有助于提高脊柱麻醉的可操作性和舒适性，促进术后肌力恢复和早期活动。
