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股骨颈骨折患者术前康复中关节囊周围神经群阻滞的应用——病例系列

Utilization of the pericapsular nerve group block in preoperative rehabilitation of patients with femoral neck fractures -a case series.

作者信息

Jin Zhuan, Sugiyama Daisuke, Higo Fumiya, Hirata Takahiro, Kobayashi Osamu, Morimatsu Hiroshi, Ueda Kenichi

机构信息

Department of Anesthesiology, Kameda Medical Center, Chiba, Japan.

Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

出版信息

Korean J Anesthesiol. 2024 Oct;77(5):565-569. doi: 10.4097/kja.24232. Epub 2024 Jun 19.

Abstract

BACKGROUND

Elderly patients with femoral neck fractures, particularly those with severe comorbidities or living in regions with limited medical resources, may experience delays in surgical treatment. Although the benefits of preoperative rehabilitation (prehabilitation) in hip arthroplasty have been reported, pain management remains a challenge. The pericapsular nerve group (PENG) block, known for its exceptional analgesic effect and motor function preservation, may be a promising intervention during prehabilitation in these patients.

CASE

We enrolled ten patients with Garden classification 3-4 femoral neck fractures scheduled for hip arthroplasty. After receiving a PENG block with 20 ml of 0.375% ropivacaine, all patients underwent initial prehabilitation sessions comprising 9 mobility levels, ranging from bed-sitting to walking. One patient was excluded due to experiencing high blood pressure during prehabilitation. Six of the nine remaining patients (66.7%) were successfully transferred from bed to wheelchair.

CONCLUSIONS

The PENG block enhanced prehabilitation for patients with femoral neck fractures undergoing hip arthroplasty.

摘要

背景

老年股骨颈骨折患者,尤其是那些患有严重合并症或生活在医疗资源有限地区的患者,手术治疗可能会延迟。尽管已有报道术前康复(预康复)在髋关节置换术中的益处,但疼痛管理仍然是一项挑战。以其卓越的镇痛效果和运动功能保留而闻名的关节囊周围神经组(PENG)阻滞,可能是这些患者在预康复期间的一种有前景的干预措施。

病例

我们纳入了10例计划进行髋关节置换术的Garden 3-4型股骨颈骨折患者。在接受20毫升0.375%罗哌卡因的PENG阻滞后,所有患者都接受了包括从坐床到行走的9个活动水平的初始预康复训练。1例患者因在预康复期间出现高血压而被排除。其余9例患者中有6例(66.7%)成功从床上转移到轮椅上。

结论

PENG阻滞增强了接受髋关节置换术的股骨颈骨折患者的预康复效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3e5/11467497/331c2a5c5a9e/kja-24232f1.jpg

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