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Kinder KD, Stambough JB, Barnes CL, Porter A, Mears SC, Stronach BM. Pericapsular Nerve Group Block Did Not Reduce Postoperative Pain or Opioid Use After Total Hip Arthroplasty. J Arthroplasty 2024; 39:S112-S116. [PMID: 39019412 PMCID: PMC11339861 DOI: 10.1016/j.arth.2024.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND The pericapsular nerve group (PENG) block is a newly developed regional anesthesia technique designed to manage postoperative hip pain following a fracture or surgery while also maintaining quadriceps strength and mobility. The goal of our study was to compare postoperative pain scores and opioid usage during the postoperative period before discharge following total hip arthroplasty (THA) using the posterior approach between patients who received a PENG block and those who did not. METHODS We conducted a retrospective study on patients undergoing elective, posterior approach THA at a single tertiary-care academic center. The 2 groups included a study group (THA with PENG block in 2021; n = 66) and a control group (THA before PENG block implementation in 2019; n = 70). RESULTS There were no significant differences in pain scores during postoperative minutes 0 to 59 (study group 6.8; control group 6.6; P = .81) or during postoperative minutes 60 to 119 (study group 6.2; control group 5.6; P = .40). There were no significant differences in total postoperative in-hospital morphine milliequivalent opioid consumption (study group 55.8 morphine milligram equivalents; control group 75.0 morphine milligram equivalents; P = .14). The study group was found to have a shorter length of stay (study group 17.0 hours; control group 32.6 hours; P < .0001) and faster mobilization (study group 3.0 hours; control group 4.9 hours; P < .0001) than the control group. CONCLUSIONS Our results show that use of the PENG block did not result in lower postoperative pain scores or opioid consumption after THA using the posterior surgical approach. The study group had a shorter length of stay and time to mobilization than the control group, though this was likely due to standard hospital procedure shifting to same-day discharge for THA between 2019 and 2021 due to COVID-19.
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Affiliation(s)
- Kathleen D. Kinder
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72202
| | - Jeffrey B. Stambough
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72202
| | - C. Lowry Barnes
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72202
| | - Austin Porter
- Department of Health Policy & Management, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72202
| | - Simon C Mears
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72202
| | - Benjamin M. Stronach
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72202
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Pavithra B, Balaji R, Kumaran D, Gayathri B. Comparing the Efficacy of Landmark-Based Fascia Iliaca Compartment Block and Pericapsular Nerve Group Block for Preoperative Positioning and Postoperative Analgesia in Patients Undergoing Surgery for Hip Fractures: A Randomized Controlled Trial. Cureus 2024; 16:e67196. [PMID: 39295686 PMCID: PMC11409903 DOI: 10.7759/cureus.67196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 08/19/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND Subarachnoid block is the most common anesthetic technique for patients having corrective hip surgeries. However, adequate positioning for a successful subarachnoid block is a major challenge in this particular population of patients, owing to the site of fracture. Regional anesthesia, in the form of nerve blocks, is an effective means of alleviating such constraints and gives an added benefit of prolonged postoperative analgesia. The pericapsular nerve group (PENG) block and the fascia iliaca compartment block (FICB), under ultrasonography guidance, are a few examples of the commonly performed peripheral nerve blocks in such settings. However, the landmark-based techniques of nerve blockade still hold good in many resource poor settings, given the lack of ultrasonography facilities. AIM To compare the ease of spinal positioning using the patient sitting satisfaction score between the landmark-guided FICB and PENG block. MATERIALS AND METHODS This study was done on 80 patients of the American Society of Anesthesiology (ASA) grade I or II with intertrochanteric fractures of the hip joint scheduled for proximal femoral nailing. Patients were allocated into two groups of 40 each through computer generated random numbers, to receive 30 ml of 0.5% ropivacaine via the landmark-guided technique of FICB in Group F and peripheral nerve stimulator assisted landmark-guided PENG block in Group P, 30 minutes prior to spinal positioning. Time to passive leg raise (PLR) to 15 degrees and time to PLR to 30 degrees with a standard goniometer guidance at visual analogue scale (VAS) score < 4 and ease of spinal positioning through the sitting satisfaction score at the 30th minute were assessed. Any adverse effects and events of failure were noted. The duration of postoperative analgesia was measured through the time to the first dose of paracetamol on arrival at the post-anesthesia care unit. RESULTS Statistical analysis was done using JASP version (0.18.3.0) using the independent samples t-test and significance was taken when p value was < 0.001. The time to PLR to 15 degrees and 30 degrees were achieved faster in the patients who received the PENG block in comparison to the patients who received the FICB, and the average patient sitting satisfaction score was significantly higher in Group P as compared to Group F (p < 0.001). While the overall amount of analgesics used in both groups was similar, the overall period of postoperative analgesia was prolonged in Group F compared to Group P (p < 0.001). CONCLUSION The landmark guided PENG block is feasible and superior to the landmark-guided FICB for preoperative positioning and analgesia. The FICB provides a longer duration of postoperative analgesia for patients with intertrochanteric fractures.
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Affiliation(s)
| | - Ramamurthy Balaji
- Anaesthesiology, SRM Medical College Hospital and Research Centre, Chennai, IND
| | - Dheepak Kumaran
- Anaesthesiology, SRM Medical College Hospital and Research Centre, Chennai, IND
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Ramlogan R, Uppal V. Hip fracture analgesia: how far ahead are we? Can J Anaesth 2024; 71:692-697. [PMID: 38097816 DOI: 10.1007/s12630-023-02664-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 08/31/2023] [Accepted: 09/19/2023] [Indexed: 02/16/2024] Open
Affiliation(s)
- Reva Ramlogan
- Department of Anesthesiology & Pain Medicine, University of Ottawa, The Ottawa Hospital, 1053 Carling Ave., Ottawa, ON, K1Y 4E9, Canada.
| | - Vishal Uppal
- Department of Anesthesia, Perioperative Medicine and Pain Management, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
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Liu M, Gao M, Hu Y, Ren X, Li Y, Gao F, Dong J, Dong J, Wang Q. Comparison of the Effect of Pericapsular Nerve Group Block Combined with Lateral Femoral Cutaneous Nerve Block and Fascia Iliaca Compartment Block in Patients Undergoing Hip Arthroscopy Under General Anesthesia: A Randomized, Double-Blind Trial. J Pain Res 2024; 17:1651-1661. [PMID: 38736679 PMCID: PMC11086438 DOI: 10.2147/jpr.s456880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose Patients undergoing arthroscopic hip surgery (AHS) require good analgesia and early rehabilitation after surgery, and there is no consensus on the optimal nerve block. We aimed to compare the efficacy of the pericapsular nerve group (PENG) block with lateral femoral cutaneous nerve (LFCN) block compared to fascia iliaca compartment block (FICB) in patients with AHS. Patients and Methods A total of 80 patients receiving AHS under general anesthesia were randomized to receive either FICB (group F) or PENG block in combination with LFCN block (group P). The primary outcomes were the rate of quadriceps weakness after block on the afflicted side, as well as muscle strength grading and pain score after block, and the quality of recovery on the second postoperative day. Results Compared with group F, group P had a lower incidence of quadriceps weakness 48 h after block (76.9% vs 28.2%, P < 0.001), and had less impact on muscle strength grade and lower static pain score at 6, 12, 18, 24, 36, and 48 h after block (P < 0.001), and a lower dynamic pain score at 6 and 12 h after block in group P (p < 0.05). The quality of recovery on the second postoperative day improved (p < 0.05). Conclusion In comparison to FICB, PENG block in combination with LFCN block can affect less quadriceps muscle strength and reduce the use of postoperative analgesics, which is beneficial for the postoperative recovery of AHS patients.
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Affiliation(s)
- Menglin Liu
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Mingyang Gao
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Yufei Hu
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Xiaoqin Ren
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Yanan Li
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Fang Gao
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Jianglong Dong
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Jiangtao Dong
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Qiujun Wang
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
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Pascarella G, Costa F, Strumia A, Ruggiero A, Remore LM, Lanteri T, Hazboun A, Longo F, Gargano F, Schiavoni L, Mattei A, Agrò FE, Carassiti M, Cataldo R. Lateral Femoral Cutaneous Nerve Block or Wound Infiltration Combined with Pericapsular Nerve Group (PENG) Block for Postoperative Analgesia following Total Hip Arthroplasty through Posterior Approach: A Randomized Controlled Trial. J Clin Med 2024; 13:2674. [PMID: 38731203 PMCID: PMC11084625 DOI: 10.3390/jcm13092674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/28/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Pericapsular nerve group (PENG) block, although effective for pain management following total hip arthroplasty (THA), does not cover skin analgesia. In this randomized controlled trial, we compared the effectiveness of PENG block combined with lateral femoral cutaneous nerve (LFCN) block or wound infiltration (WI) on postoperative analgesia and functional outcomes. Methods: Fifty patients undergoing posterior-approached THA under spinal anesthesia were randomly allocated to receive LFCN block with 10 mL of 0.5% ropivacaine or WI with 20 mL of 0.5% ropivacaine. In both groups, PENG block was performed by injecting 20 mL of 0.5% ropivacaine. Primary outcomes were static and dynamic pain scores (0-10 numeric rating scale) measured in the first 24 h after surgery. Secondary outcomes included postoperative opioid consumption, functional assessment and length of hospital stay. Results: Postoperative static NRS of patients receiving LFCN was higher than that of patients receiving WI at 6 h but lower at 24 h, with a median (IQR) of 3 (2-4) vs. 2 (1-2) (p < 0.001) and 2 (2-3) vs. 3 (3-4) (p = 0.02), respectively. Static pain scores at 12 h did not show significant differences, with an NRS of 3 (2-4) for WI vs. 3 (3-4) for LFCN (p = 0.94). Dynamic pain and range of movement followed a similar trend. No significant differences were detected in other outcomes. Conclusions: LFCN block was not inferior to WI for postoperative analgesia and functional recovery in association with PENG block during the first postoperative day, although it had worse short-term pain scores. Based on these results, it is reasonable to consider LFCN block as a valid alternative to WI or even a complementary technique added to WI to enhance skin analgesia during the first 24 h after THA. Future studies are expected to confirm this hypothesis and find the best combination between PENG block and other techniques to enhance analgesia after THA.
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Affiliation(s)
- Giuseppe Pascarella
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Fabio Costa
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Alessandro Strumia
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Alessandro Ruggiero
- Unit of Anesthesia and Intensive Care, Department of Medicine, Università Campus Bio-Medico, 00128 Rome, Italy;
| | - Luigi Maria Remore
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Tullio Lanteri
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Anton Hazboun
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Ferdinando Longo
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Francesca Gargano
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Lorenzo Schiavoni
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Alessia Mattei
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
| | - Felice Eugenio Agrò
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
- Unit of Anesthesia and Intensive Care, Department of Medicine, Università Campus Bio-Medico, 00128 Rome, Italy;
| | - Massimiliano Carassiti
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
- Unit of Anesthesia and Intensive Care, Department of Medicine, Università Campus Bio-Medico, 00128 Rome, Italy;
| | - Rita Cataldo
- Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (G.P.); (F.C.); (L.M.R.); (T.L.); (A.H.); (F.L.); (F.G.); (L.S.); (A.M.); (F.E.A.); (M.C.); (R.C.)
- Unit of Anesthesia and Intensive Care, Department of Medicine, Università Campus Bio-Medico, 00128 Rome, Italy;
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Girombelli A, Vetrone F, Saglietti F, Galimberti A, Fusaro A, Umbrello M, Pezzi A. Pericapsular nerve group block and lateral femoral cutaneous nerve block versus fascia iliaca block for multimodal analgesia after total hip replacement surgery: A retrospective analysis. Saudi J Anaesth 2024; 18:218-223. [PMID: 38654885 PMCID: PMC11033891 DOI: 10.4103/sja.sja_881_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 04/26/2024] Open
Abstract
Background Optimal pain control with limited muscle weakness is paramount for a swift initiation of physical therapy and early discharge. Fascia iliaca compartment block (FICB) has been recommended since it offers good pain control with a low risk of motor block. Pericapsular nerve group (PENG) block with lateral femoral cutaneous block (LFCN) has been proposed as an effective alternative to FICB that offers better pain control with a considerably lower risk of motor block. We aimed to compare the aforementioned blocks and determine which one yielded the lowest numeric rating scale (NRS) score. Methods We designed a retrospective analysis of patients undergoing elective total hip arthroplasty. The primary outcome was the NRS score at 6, 12, and 24 hours. The secondary outcomes were total opioid consumption, time to first PRN opioid, and time to first postoperative ambulation. Results 52 patients were recruited, (13 PENG plus LFCN, 39 FICB). PENG plus LCFN resulted in a lower NRS at all three-time points (mean difference and 95%CI at 6 h 0.378 [-0.483; 1.240], at 12 h 0.336 [-0.378; 1.050], and at 24 h 0.464 [0.013; 0.914] P = 0.02). Moreover, less PRN opioids were requested in the PENG plus LCFN vs. FICB group (0 [0;7.5] vs 60 [15;80] milligrams of morphine equivalents, P = 0.001). No delay in the first ambulation or initiation of physical rehabilitation was reported in either group. Conclusions PENG plus LCFN seems to offer better pain control and lead to less PRN opioids. Neither block hindered physical therapy nor ambulation. These results need to be confirmed with a larger prospective and randomized study.
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Affiliation(s)
- Alessandro Girombelli
- Department of Anesthesiology, Division of Anesthesiology, Intensive Care and Emergency Medicine, EOC, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Francesco Vetrone
- Department of Surgery and Emergency, Anesthesiology and Critical Care Medicine, ASST Nord Milano, Bassini Hospital, Cinisello Balsamo (MI), Italy
| | - Francesco Saglietti
- Department of Anesthesiology and Critical Care Medicine, Azienda Ospedaliera S. Croce e Carle, Cuneo (CN), Italy
| | - Andrea Galimberti
- Department of Surgery and Emergency, Anesthesiology and Critical Care Medicine, ASST Nord Milano, Bassini Hospital, Cinisello Balsamo (MI), Italy
| | - Andrea Fusaro
- Orthopedic Surgery Division, ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo (MI), Italy
| | - Michele Umbrello
- Anesthesiology and Critical Care Medicine, SC Anestesia e Rianimazione II, ASST Santi Paolo e Carlo – Polo Universitario, Ospedale San Carlo Borromeo, Milano (MI), Italy
| | - Angelo Pezzi
- Department of Surgery and Emergency, Anesthesiology and Critical Care Medicine, ASST Nord Milano, Bassini Hospital, Cinisello Balsamo (MI), Italy
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Tsurumachi N, Saima S, Okuda Y. Inadvertent inhibitory effect of epidural anesthesia on motor-evoked potential (MEP) monitoring in a patient undergoing total hip arthroplasty. J Anesth 2024; 38:286-287. [PMID: 38055075 DOI: 10.1007/s00540-023-03289-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/16/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Naoi Tsurumachi
- Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan.
| | - Shunsuke Saima
- Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Yasuhisa Okuda
- Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
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Ke J, Yang Y, Cao Y, Wang Y, Lin C. Efficacy and safety of pericapsular nerve group block in total hip arthroplasty: a meta-analysis and systematic review. Minerva Anestesiol 2024; 90:200-209. [PMID: 37987992 DOI: 10.23736/s0375-9393.23.17618-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Ensuring effective perioperative pain control is a crucial aspect of rehabilitation programs following total hip arthroplasty. This study presents a comprehensive meta-analysis and systematic review to assess the efficacy and safety of pericapsular nerve group block (PENG) in the context of total hip arthroplasty. EVIDENCE ACQUISITION A systematic search was conducted in multiple databases, including PubMed, Embase, Cochrane Library, and Web of Science, to identify relevant randomized controlled studies investigating the efficacy and safety of PENG for total hip arthroplasty. The search was conducted up until 1st June 2023. Data analysis was performed using Stata v. 15.0. EVIDENCE SYNTHESIS A total of 721 individuals participated in this study, which included 13 randomized controlled trials. Among them, 377 individuals were assigned to the experimental group, while 344 individuals were assigned to the control group. The findings from the meta-analysis indicated that the application of PENG yielded favorable outcomes in terms of reducing six-hour pain scores (SMD=-0.63, 95% CI -1.18, -0.09) and 24-hour pain scores (SMD=-1.45, 95% CI -2.51, -0.29). Moreover, it was found to decrease opioid consumption (SMD=-0.84, 95% CI -1.35, -0.34), without causing a significant increase in nausea and vomiting (RR=0.75, 95% CI 0.45, 1.23) or urinary retention (RR=2.46, 95% CI 0.49, 12.31). CONCLUSIONS Based on the latest findings, PENG has been shown to effectively decrease pain scores within six and 24 hours following total hip arthroplasty. However, its effectiveness in pain control diminishes after 48 hours. Additionally, PENG has demonstrated the ability to reduce opioid consumption without an accompanying increase in adverse drug events.
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Affiliation(s)
- Jinyong Ke
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yang Yang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yang Cao
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuyan Wang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chunshui Lin
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China -
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