Özgüner Yusuf, Altinsoy Savaş, Kültüroğlu Gökçen, Gürpinar Sevda Gökçe, Özkan Derya, Ergil Jülide, Aydin Erbil
Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Turkiye.
Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkiye.
Turk J Med Sci. 2025 Apr 22;55(4):860-867. doi: 10.55730/1300-0144.6038. eCollection 2025.
BACKGROUND/AIM: The pericapsular nerve group (PENG) block is an effective method for pain management in patients with hip fractures. In our study, we compared three different local anesthetic volumes of the PENG block in patients who underwent surgery for hip fracture.
Patients who underwent surgery with spinal anesthesia for intertrochanteric femur fractures (60 patients) were divided into three groups based on the volume of local anesthetic administered: Group 1 (20 mL), Group 2 (30 mL), and Group 3 (40 mL). Postoperative patient-controlled analgesia was initiated. Postoperative tramadol consumption, rest and movement pain scores, and the duration of motor block were monitored.
We found that Group 2 (118 ± 35.48 mg) and Group 3 (115 ± 42.98 mg) had reduced tramadol consumption compared to Group 1 (151 ± 31.43 mg) (p < 0.05). However, Group 3 (161 ± 18.6 min) had a longer duration of motor block (time to reach a Bromage score of 0) compared to Group 1 (132.25 ± 13.71 min) and Group 2 (143.5 ± 19.54 min) (p < 0.05).
We found that the 30 mL and 40 mL volumes in the PENG block resulted in lower tramadol consumption compared to the 20 mL volume. We believe that the 30 mL volume is the most appropriate option among the three volumes, as it provides similar analgesic efficacy to the 40 mL volume but causes less motor block.
背景/目的：关节囊周围神经组（PENG）阻滞是髋部骨折患者疼痛管理的有效方法。在我们的研究中，我们比较了接受髋部骨折手术患者中三种不同局部麻醉药用量的PENG阻滞效果。
接受腰麻下股骨粗隆间骨折手术的患者（60例）根据局部麻醉药用量分为三组：第1组（20 mL）、第2组（30 mL）和第3组（40 mL）。术后开始患者自控镇痛。监测术后曲马多消耗量、休息和活动时的疼痛评分以及运动阻滞持续时间。
我们发现，与第1组（151±31.43 mg）相比，第2组（118±35.48 mg）和第3组（115±42.98 mg）的曲马多消耗量减少（p<0.05）。然而，与第1组（132.25±13.71分钟）和第2组（143.5±19.54分钟）相比，第3组（161±18.6分钟）的运动阻滞持续时间更长（达到布罗玛杰评分0的时间）（p<0.05）。
我们发现，与20 mL用量相比，PENG阻滞中30 mL和40 mL用量导致曲马多消耗量更低。我们认为，30 mL用量是这三种用量中最合适的选择，因为它与40 mL用量具有相似的镇痛效果，但引起的运动阻滞较小。
