Udvarhelyi Anna, Kiss Anett, Hangody László Rudolf, Domaraczki Olivér, Mátyás Viktor, Kopitkó Csaba
Department of Anesthesiology and Intensive Therapy, Pain Clinic; Uzsoki Teaching Hospital of Semmelweis University, H-1145, Budapest, Uzsoki u. 29-41, Hungary.
Jt Dis Relat Surg. 2025 Jul 21;36(3):543-554. doi: 10.52312/jdrs.2025.2179.
The aim of this study was to evaluate the efficacy of pericapsular nerve group block (PENG) and genicular neurolysis performed with ethyl alcohol in the management of pain associated with hip or knee osteoarthritis or persistent postoperative pain following arthroplasty.
Between October 2023 and June 2024, a total of 89 ambulatory adult patients (70 males, 19 females; median age: 75.5 [IQR: 62.6 to 81.3] years; range: 46.7 to 92.8 years) who visited our pain clinic were retrospectively analyzed. The PENG or genicular nerve neurolysis was performed as appropriate using ethyl alcohol. Median and maximum level of pain according to patient self-report was registered before and after the interventions.
A total of 33 patients presenting with hip pain and 56 patients presenting with knee pain were treated. Considering the reported median pain, the median intensity reduced from 7.5 to 3.5 for hip pain, whereas in the knee group the median intensity of pain was 7.0 before the intervention and 3.0 after the procedure. The median intensity of reported maximal pain reduced from 10 to 6.8 for the hip, and from 8.8 to 6.5 for the knee pain.
Alcoholic neurolysis offers a promising, cost-effective new approach for the management of pain in the absence of radiofrequency. It provides sustained pain relief until surgical arthroplasty of the hip or knee joint and is also beneficial in the management of persistent pain following surgery or for patients who are ineligible for surgical intervention.
本研究旨在评估关节周围神经丛阻滞（PENG）和用乙醇进行的膝关节神经松解术在治疗与髋或膝骨关节炎相关的疼痛或关节置换术后持续疼痛中的疗效。
回顾性分析2023年10月至2024年6月期间前来我们疼痛门诊就诊的89例门诊成年患者（70例男性，19例女性；中位年龄：75.5岁[四分位间距：62.6至81.3岁]；范围：46.7至92.8岁）。根据情况使用乙醇进行PENG或膝关节神经松解术。记录干预前后患者自我报告的疼痛中位水平和最高水平。
共治疗了33例髋部疼痛患者和56例膝部疼痛患者。考虑到报告的中位疼痛，髋部疼痛的中位强度从7.5降至3.5，而在膝关节组中，干预前疼痛的中位强度为7.0，术后为3.0。报告的最大疼痛的中位强度，髋部从10降至6.8，膝部疼痛从8.8降至6.5。
在没有射频设备的情况下，酒精神经松解术为疼痛管理提供了一种有前景、经济有效的新方法。它能持续缓解疼痛，直至进行髋或膝关节置换手术，并且对术后持续性疼痛的管理或对不适合手术干预的患者也有益。
