Cho Hun Sik, Lee Bo Ra, Kwon Hyuck Min, Park Jun Young, Ham Hyeong Won, Lee Woo-Suk, Park Kwan Kyu, Lee Tae Sung, Choi Yong Seon
Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2025 Apr;66(4):233-239. doi: 10.3349/ymj.2024.0098.
The purpose of this study was to compare the effectiveness of pericapsular nerve group (PENG) block with periarticular multimodal drug injection (PMDI) on postoperative pain management and surgical outcomes in patients who underwent total hip arthroplasty (THA). We hypothesized that PENG block with PMDI would exhibit superior effects on postoperative pain control after THA compared to PMDI alone.
From April 2022 to February 2023, 58 patients who underwent THA were randomly assigned into two groups: PENG block with PMDI group (n=29) and PMDI-only group (n=29). Primary outcomes were postoperative numeric rating scale (NRS) at rest and during activity at 6, 24, and 48 hours postoperatively. Secondary outcomes were postoperative complications (nausea and vomiting), Richards-Campbell Sleep Questionnaire (RCSQ) score, length of hospital stay, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, Harris Hip Score (HHS), and total morphine usage after surgery.
There was no significant difference in postoperative pain for either resting NRS or active NRS. Postoperative nausea and vomiting, RCSQ score, length of hospital stay, WOMAC index, HHS, and total morphine usage exhibited no significant differences between the two groups.
Both groups showed no significant differences in postoperative pain and clinical outcomes, indicating that the addition of PENG block to PMDI does not improve pain management after applying the posterolateral approach of THA. PMDI alone during THA would be an efficient, fast, and safe method for managing postoperative pain. This article was registered with ClinicalTrials. gov (Gov ID: NCT05320913).
本研究旨在比较关节囊周围神经组（PENG）阻滞与关节周围多模式药物注射（PMDI）在全髋关节置换术（THA）患者术后疼痛管理及手术效果方面的有效性。我们假设，与单纯PMDI相比，PENG阻滞联合PMDI在THA术后疼痛控制方面具有更优效果。
2022年4月至2023年2月，58例行THA的患者被随机分为两组：PENG阻滞联合PMDI组（n = 29）和单纯PMDI组（n = 29）。主要结局指标为术后6、24和48小时静息及活动时的数字评分量表（NRS）。次要结局指标为术后并发症（恶心和呕吐）、理查兹 - 坎贝尔睡眠问卷（RCSQ）评分、住院时间、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、Harris髋关节评分（HHS）以及术后吗啡总用量。
静息NRS或活动NRS的术后疼痛方面两组无显著差异。两组在术后恶心呕吐、RCSQ评分、住院时间、WOMAC指数、HHS及吗啡总用量方面均无显著差异。
两组在术后疼痛及临床结局方面均无显著差异，表明在采用THA后外侧入路时，PENG阻滞联合PMDI并未改善疼痛管理。THA术中单纯PMDI是一种有效、快速且安全的术后疼痛管理方法。本文已在ClinicalTrials.gov注册（注册号：NCT05320913）。
