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关节囊周围神经群阻滞未能减少全髋关节置换术后的疼痛或阿片类药物的使用。

Pericapsular Nerve Group Block Did Not Reduce Postoperative Pain or Opioid Use After Total Hip Arthroplasty.

机构信息

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Department of Health Policy & Management, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

出版信息

J Arthroplasty. 2024 Sep;39(9S1):S112-S116. doi: 10.1016/j.arth.2024.06.043. Epub 2024 Jul 15.

Abstract

BACKGROUND

The pericapsular nerve group (PENG) block is a newly developed regional anesthesia technique designed to manage postoperative hip pain following a fracture or surgery while also maintaining quadriceps strength and mobility. The goal of our study was to compare postoperative pain scores and opioid usage during the postoperative period before discharge following total hip arthroplasty (THA) using the posterior approach between patients who received a PENG block and those who did not.

METHODS

We conducted a retrospective study on patients undergoing elective, posterior approach THA at a single tertiary-care academic center. The 2 groups included a study group (THA with PENG block in 2021; n = 66) and a control group (THA before PENG block implementation in 2019; n = 70).

RESULTS

There were no significant differences in pain scores during postoperative minutes 0 to 59 (study group 6.8; control group 6.6; P = .81) or during postoperative minutes 60 to 119 (study group 6.2; control group 5.6; P = .40). There were no significant differences in total postoperative in-hospital morphine milliequivalent opioid consumption (study group 55.8 morphine milligram equivalents; control group 75.0 morphine milligram equivalents; P = .14). The study group was found to have a shorter length of stay (study group 17.0 hours; control group 32.6 hours; P < .0001) and faster mobilization (study group 3.0 hours; control group 4.9 hours; P < .0001) than the control group.

CONCLUSIONS

Our results show that use of the PENG block did not result in lower postoperative pain scores or opioid consumption after THA using the posterior surgical approach. The study group had a shorter length of stay and time to mobilization than the control group, though this was likely due to standard hospital procedure shifting to same-day discharge for THA between 2019 and 2021 due to COVID-19.

摘要

背景

囊周神经群(PENG)阻滞是一种新开发的区域麻醉技术,旨在管理骨折或手术后的髋关节疼痛,同时保持股四头肌力量和活动度。我们的研究目的是比较使用后路行全髋关节置换术(THA)后,接受 PENG 阻滞的患者与未接受 PENG 阻滞的患者在出院前的术后疼痛评分和阿片类药物使用情况。

方法

我们对在一家三级学术中心行择期后路 THA 的患者进行了回顾性研究。两组患者分别为研究组(2021 年行 PENG 阻滞的 THA;n=66)和对照组(2019 年行 PENG 阻滞前的 THA;n=70)。

结果

术后 0 至 59 分钟(研究组 6.8;对照组 6.6;P=.81)和术后 60 至 119 分钟(研究组 6.2;对照组 5.6;P=.40)的疼痛评分无显著差异。术后住院期间总吗啡毫当量阿片类药物消耗量也无显著差异(研究组 55.8 吗啡毫克当量;对照组 75.0 吗啡毫克当量;P=.14)。研究组的住院时间更短(研究组 17.0 小时;对照组 32.6 小时;P <.0001),下床活动时间更快(研究组 3.0 小时;对照组 4.9 小时;P <.0001)。

结论

我们的结果表明,后路 THA 中使用 PENG 阻滞并不能降低术后疼痛评分或阿片类药物的使用量。与对照组相比,研究组的住院时间和下床活动时间更短,但这可能是由于 COVID-19 导致 2019 年至 2021 年间医院程序转变为 THA 术后当日出院。

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Pericapsular nerve group block: an overview.囊周神经群阻滞:概述。
Minerva Anestesiol. 2021 Apr;87(4):458-466. doi: 10.23736/S0375-9393.20.14798-9. Epub 2021 Jan 12.

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