Li Yapeng, Li Feng, Zhang Zhijie, Guo Jiayi, Yue Chen
Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China.
Evidence-based Medicine Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China.
EFORT Open Rev. 2025 Aug 4;10(8):589-599. doi: 10.1530/EOR-2024-0105.
The objective of this study was to assess the benefits of the PENG block on pain control and functional recovery.
Randomized controlled trials in PubMed, Web of Science, Embase, and the Cochrane Library were selected, and data were meta-analyzed using a random-effects model to estimate mean difference (MD) or standardized mean differences (SMD).
Eleven trials involving 1,135 patients were included. The PENG block was associated with significantly lower total opioid consumption than sham/no block (MD: -25.23, 95% CI: -27.01 to -23.45, I 2 = 0%), as well as better functional recovery. The PENG block was noninferior to the suprainguinal fascia iliaca block regarding postoperative pain scores and functional recovery and had a significant reduction in total opioid consumption (MD: -8.25, 95% CI: -16.48 to -0.02, I 2 = 68%). The PENG block was associated with similar total opioid consumption and functional recovery as the periarticular anesthetic infiltration (PAI), but worse static pain scores at 12 h (SMD: 0.41, 95% CI: 0.08-0.75, I 2 = 51%) and dynamic pain scores at 48 h after surgery (SMD: 0.36, 95% CI: 0.08-0.64, I 2 = 0%).
While current evidence supports the PENG block as a viable alternative to other types of peripheral analgesia in THA, existing data remain insufficient to conclude that the PENG block outperforms other peripheral analgesia when it comes to pain control or functional recovery. More well-designed randomized controlled trials are needed in the future to thoroughly explore whether the PENG block has superiority over other analgesic techniques.
本研究的目的是评估腰大肌-髂耻束阻滞（PENG阻滞）在疼痛控制和功能恢复方面的益处。
选取PubMed、Web of Science、Embase和Cochrane图书馆中的随机对照试验，并使用随机效应模型对数据进行荟萃分析，以估计平均差（MD）或标准化平均差（SMD）。
纳入了涉及1135例患者的11项试验。PENG阻滞与假手术/无阻滞相比，总阿片类药物消耗量显著更低（MD：-25.23，95%置信区间：-27.01至-23.45，I² = 0%），且功能恢复更好。在术后疼痛评分和功能恢复方面，PENG阻滞不劣于腹股沟上髂筋膜阻滞，且总阿片类药物消耗量显著降低（MD：-8.25，95%置信区间：-16.48至-0.02，I² = 68%）。PENG阻滞与关节周围麻醉浸润（PAI）的总阿片类药物消耗量和功能恢复相似，但术后12小时的静态疼痛评分更差（SMD：0.41，95%置信区间：0.08 - 0.75，I² = 51%），术后48小时的动态疼痛评分也更差（SMD：0.36，95%置信区间：0.08 - 0.64，I² = 0%）。
虽然目前的证据支持PENG阻滞作为全髋关节置换术（THA）中其他类型外周镇痛的可行替代方法，但现有数据仍不足以得出在疼痛控制或功能恢复方面PENG阻滞优于其他外周镇痛方法的结论。未来需要更多设计良好的随机对照试验，以彻底探究PENG阻滞是否优于其他镇痛技术。
