Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, No. 516, Jinrong South Road, Fuzhou, 350001, Fujian, China.
Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, China.
BMC Anesthesiol. 2024 Nov 21;24(1):421. doi: 10.1186/s12871-024-02805-1.
As a fascial plane block technique, further exploration is needed to determine the safety and efficacy of a peri-capsular nerve group (PENG) block in elderly patients with intertrochanteric femur fractures. We aimed to evaluate whether opioid consumption during a PENG block is better than a conventional opioid-based program for postoperative pain management after proximal femoral nail anti-rotation (PFNA).
We conducted a prospective, randomized, controlled trial comparing the efficacy of the PENG block with the control group for elderly patients undergoing primary PFNA under general anesthesia. The primary outcome was the cumulative administration of sufentanil during the first 48 h after surgery.
110 participants (55 in each group) were included in the analysis. Cumulative Sufentanil consumption between the PENG group and the control group at 48 h was 132.6 ± 12.3 vs. 141.0 ± 15.3, with a difference of -8.4; 95% CI, -13.6 to -3.1, P = 0.002. Sufentanil consumption at 24 h was 78.3 ± 6.1 vs. 94.0 ± 10.2, with a difference of -15.7; 95% CI, -18.9 to -12.5, P < 0.001. There were statistical differences in the visual analogue scale score trajectories between the two groups at 48 h postoperatively (P < 0.001). The median time to first remedial analgesia was lower in the PENG block group than in the control group (P < 0.001). However, there was no difference in the time to first standing.
Incorporating the PENG block into a multimodal analgesia regimen can decrease opioid consumption among elderly patients undergoing PFNA under general anesthesia.
The study was registered in the Chinese Clinical Trial Registry (ChiCTR2100054290, principal investigator: Xiao-dan, Wu, 13/12/2021).
作为一种筋膜平面阻滞技术，需要进一步探索经囊周神经群（PENG）阻滞在老年股骨转子间骨折患者中的安全性和有效性。我们旨在评估 PENG 阻滞在股骨近端防旋髓内钉（PFNA）术后的镇痛效果是否优于常规阿片类药物方案。
我们进行了一项前瞻性、随机、对照试验，比较了 PENG 阻滞与对照组在全身麻醉下接受初次 PFNA 的老年患者的疗效。主要结局是术后 48 小时内舒芬太尼的累积给药量。
共有 110 名参与者（每组 55 名）纳入分析。PENG 组和对照组在 48 小时时的累积舒芬太尼消耗量分别为 132.6±12.3μg 和 141.0±15.3μg，差值为-8.4μg；95%CI，-13.6 至-3.1，P=0.002。24 小时时舒芬太尼消耗量分别为 78.3±6.1μg 和 94.0±10.2μg，差值为-15.7μg；95%CI，-18.9 至-12.5，P<0.001。两组术后 48 小时时视觉模拟评分轨迹存在统计学差异（P<0.001）。PENG 阻滞组首次补救性镇痛的中位时间低于对照组（P<0.001）。然而，首次站立时间无差异。
将 PENG 阻滞纳入多模式镇痛方案可减少全身麻醉下接受 PFNA 的老年患者的阿片类药物用量。
该研究在中国临床试验注册中心注册（ChiCTR2100054290，主要研究者：吴晓丹，13/12/2021）。
