Liu Menglin, Gao Mingyang, Hu Yufei, Ren Xiaoqin, Li Yanan, Gao Fang, Dong Jianglong, Dong Jiangtao, Wang Qiujun
Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People's Republic of China.
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People's Republic of China.
J Pain Res. 2024 May 6;17:1651-1661. doi: 10.2147/JPR.S456880. eCollection 2024.
Patients undergoing arthroscopic hip surgery (AHS) require good analgesia and early rehabilitation after surgery, and there is no consensus on the optimal nerve block. We aimed to compare the efficacy of the pericapsular nerve group (PENG) block with lateral femoral cutaneous nerve (LFCN) block compared to fascia iliaca compartment block (FICB) in patients with AHS.
A total of 80 patients receiving AHS under general anesthesia were randomized to receive either FICB (group F) or PENG block in combination with LFCN block (group P). The primary outcomes were the rate of quadriceps weakness after block on the afflicted side, as well as muscle strength grading and pain score after block, and the quality of recovery on the second postoperative day.
Compared with group F, group P had a lower incidence of quadriceps weakness 48 h after block (76.9% vs 28.2%, P < 0.001), and had less impact on muscle strength grade and lower static pain score at 6, 12, 18, 24, 36, and 48 h after block (P < 0.001), and a lower dynamic pain score at 6 and 12 h after block in group P ( < 0.05). The quality of recovery on the second postoperative day improved ( < 0.05).
In comparison to FICB, PENG block in combination with LFCN block can affect less quadriceps muscle strength and reduce the use of postoperative analgesics, which is beneficial for the postoperative recovery of AHS patients.
接受关节镜髋关节手术(AHS)的患者术后需要良好的镇痛和早期康复,目前对于最佳神经阻滞方法尚无共识。我们旨在比较关节囊周围神经组(PENG)阻滞联合股外侧皮神经(LFCN)阻滞与髂筋膜间隙阻滞(FICB)在AHS患者中的疗效。
总共80例在全身麻醉下接受AHS的患者被随机分为接受FICB(F组)或PENG阻滞联合LFCN阻滞(P组)。主要结局指标为阻滞后患侧股四头肌无力发生率、阻滞后肌肉力量分级和疼痛评分,以及术后第二天的恢复质量。
与F组相比,P组在阻滞后48小时股四头肌无力发生率更低(76.9%对28.2%,P<0.001),在阻滞后6、12、18、24、36和48小时对肌肉力量分级影响更小且静态疼痛评分更低(P<0.001),P组在阻滞后6和12小时动态疼痛评分更低(<0.05)。术后第二天恢复质量有所改善(<0.05)。
与FICB相比,PENG阻滞联合LFCN阻滞对股四头肌力量影响较小,可减少术后镇痛药的使用,有利于AHS患者的术后恢复。