Kaplan Burcu, Özden Eyyüp Sabri, Özcan Mustafa Soner, Alkaya Solmaz Filiz, Kırdemir Pakize
Süleyman Demirel University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Isparta, Turkey.
Turk J Anaesthesiol Reanim. 2024 Dec 16;52(6):223-230. doi: 10.4274/TJAR.2024.241636.
We intended to research the efficacy of pericapsular nerve group (PENG) block performed with preoperative ultrasonography (USG) in patients who underwent hip fracture repair under spinal anaesthesia and whether it affects the success of spinal anaesthesia.
The files of 100 patients were analysed, and 60 patients were enrolled in the study. The patients were assigned into two groups: Group P (n = 30) consisted of patients who underwent USG-guided PENG block before the start of surgery and the control group (Group C; n = 30) consisted of patients in whom tramadol infusion was initiated. All patients received 10 mg IV bolus tramadol as rescue analgesia when numeric rating scale (NRS)>3. From the files of the patients, before PENG block application, after PENG block application, during positioning before spinal anaesthesia, the NRS values at the time of the patient's discharge from the operating room and at 2, 4, 12 and 24 hour NRS values, spinal anaesthesia duration and number of attempts, and perioperative total tramadol consumption were obtained.
In group P, NRS values were found to be significantly lower after PENG block application, during positioning before spinal anaesthesia, and at the postoperative discharge, 2, 4, 12 and 24 hours. In addition, group P had a lower duration of spinal anaesthesia, a lower number of spinal anaesthesia attempts and a lower total perioperative tramadol consumption.
The results demonstrated that preoperative PENG block facilitated positioning for spinal anaesthesia, shortened the application time, increased the first-attempt success rate, decreased pain scores, and reduced the need for postoperative opioids.
我们旨在研究术前超声检查(USG)引导下的关节周围神经群(PENG)阻滞在接受脊髓麻醉的髋部骨折修复患者中的疗效,以及它是否会影响脊髓麻醉的成功率。
分析了100例患者的病历,其中60例患者纳入研究。将患者分为两组:P组(n = 30)由手术开始前接受USG引导下PENG阻滞的患者组成,对照组(C组;n = 30)由开始输注曲马多的患者组成。当数字评分量表(NRS)>3时,所有患者均接受10 mg静脉推注曲马多作为补救镇痛。从患者病历中获取PENG阻滞应用前、PENG阻滞应用后、脊髓麻醉前定位时、患者离开手术室时的NRS值以及术后2、4、12和24小时的NRS值、脊髓麻醉持续时间和尝试次数,以及围手术期曲马多总消耗量。
在P组中,发现PENG阻滞应用后、脊髓麻醉前定位时以及术后出院时、术后2、4、12和24小时的NRS值显著更低。此外,P组的脊髓麻醉持续时间更短、脊髓麻醉尝试次数更少且围手术期曲马多总消耗量更低。
结果表明,术前PENG阻滞有助于脊髓麻醉的定位,缩短了应用时间,提高了首次尝试成功率,降低了疼痛评分,并减少了术后对阿片类药物的需求。