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Frassanito L, Filetici N, Canistro G, Zanfini BA, Catarci S, Draisci G. Pericapsular nerve block for analgesia in a pregnant patient with hip fracture. Minerva Anestesiol 2024; 90:586-587. [PMID: 38421353 DOI: 10.23736/s0375-9393.24.18028-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Luciano Frassanito
- Department of Emergency, Anesthesiology and Resuscitation Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy -
| | - Nicoletta Filetici
- Department of Emergency, Anesthesiology and Resuscitation Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Gennaro Canistro
- Department of Emergency, Anesthesiology and Resuscitation Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Bruno A Zanfini
- Department of Emergency, Anesthesiology and Resuscitation Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Stefano Catarci
- Department of Emergency, Anesthesiology and Resuscitation Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Gaetano Draisci
- Department of Emergency, Anesthesiology and Resuscitation Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
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Li S, An J, Qian C, Wang Z. Efficacy and Safety of Pericapsular Nerve Group Block for Hip Fracture Surgery under Spinal Anesthesia: A Meta-Analysis. Int J Clin Pract 2024; 2024:6896066. [PMID: 38510561 PMCID: PMC10954362 DOI: 10.1155/2024/6896066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/28/2024] [Accepted: 02/22/2024] [Indexed: 03/22/2024] Open
Abstract
Objective To evaluate the effectiveness and safety of pericapsular nerve group (PENG) block for hip fracture surgery under spinal anesthesia. Methods This meta-analysis was registered on INPLASY (INPLASY202270005). PubMed, Embase, Cochrane, CNKI, and Wanfang databases were searched to collect the randomized controlled trials of the PENG block applied to hip fracture surgery in the setting of spinal anesthesia, with the search period from inception to 1 May 2023. Two independent researchers gradually screened the literature, evaluated the quality, extracted the data, and eventually pooled data using RevMan 5.4. Results Fifteen articles with 890 patients were enrolled. The combined results showed that the PENG block reduced pain scores during position placement (SMD = -0.35; 95% CI [-0.67, 0.02]; P=0.04; I2 = 0%). Subgroup analyses showed that compared to the unblocked group, the PENG block reduced pain scores at 12 h, 24 h, and 48 h postoperatively. The incidence of postoperative hypokinesia was reduced (RR = 0.11; 95% CI [0.01, 0.86]; P=0.04; I2 = 0.00%). The time to first walking was advanced (SMD = -0.90; 95% CI [-1.17, 0.63]; P < 0.00001; I2 = 0%). Conclusion The PENG block can reduce postoperative pain and pain during spinal anesthesia positioning, which is helpful to improve the operability and comfort of spinal anesthesia and facilitate postoperative muscle strength recovery and early activity.
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Affiliation(s)
- Shukai Li
- Department of Anesthesiology, Affiliated Hospital of Chengde Medical University, Chengde 067000, China
| | - Jing An
- Department of Anesthesiology, Affiliated Hospital of Chengde Medical University, Chengde 067000, China
| | - Chengyu Qian
- Department of Anesthesiology, Affiliated Hospital of Chengde Medical University, Chengde 067000, China
| | - Zhixue Wang
- Department of Anesthesiology, Affiliated Hospital of Chengde Medical University, Chengde 067000, China
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Christopher S, Dutta S, Gopal TVS. Bilateral pericapsular end nerve blocks for steroid-induced avascular necrosis following COVID-19 infection requiring bilateral total hip replacement. World J Anesthesiol 2024; 13:90514. [DOI: 10.5313/wja.v13.i1.90514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/05/2024] [Accepted: 02/25/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Osteonecrosis or avascular necrosis (AVN) of the hip was one of the dreaded complications of coronavirus disease 2019 (COVID-19), which emerged in patients who received steroid therapy. Corticosteroids have been a mainstay in the treatment protocol of COVID-19 patients. Popular corticosteroid drugs used in patients suffering from COVID-19 were intravenous (IV) or oral dexamethasone, methylprednisolone or hydrocortisone. The use of such high doses of corticosteroids has shown very positive results and has been lifesaving in many cases. Still, long-term consequences were drug-induced diabetes, osteoporosis, Cushing syndrome, muscle wasting, peripheral fat mobilization, AVN, hirsutism, sleep disturbances and poor wound healing. A significant number of young patients were admitted for bilateral total hip replacements (THR) secondary to AVN following steroid use for COVID-19 treatment.
AIM To assess the efficacy of bilateral pericapsular end nerve group (PENG) blocks in patients posted for bilateral THR post-steroid therapy after COVID-19 infection and assess the time taken to first ambulate after surgery.
METHODS This prospective observational study was conducted between January 2023 and August 2023 at Care Hospitals, Hyderabad, India. Twenty young patients 30-35 years of age who underwent bilateral THR were studied after due consent over 8 months. All the patients received spinal anaesthesia for surgery and bilateral PENG blocks for postoperative analgesia.
RESULTS The duration of surgery was 2.5 h on average. Seventeen out of twenty patients (85%) had a Visual Analog Score (VAS) of less than 2 and did not require any supplementation. One patient was removed from the study, as he required re-exploration. The remaining two patients had a VAS of more than 8 and received IV morphine post-operatively as a rescue analgesic drug. Fifteen out of seventeen patients (88.2%) could be mobilized 12 h after the procedure.
CONCLUSION Osteonecrosis or AVN of the hip was one of the dreaded complications of COVID-19, which surfaced in patients who received steroid therapy requiring surgical intervention. Bilateral PENG block is an effective technique to provide post-operative analgesia resulting in early mobilization and enhanced recovery after surgery.
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Affiliation(s)
| | - Sweety Dutta
- Department of Anaesthesiology, Care Hospitals, Hyderabad 500025, India
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Eppel B, Schneider MM, Gebhardt S, Balcarek P, Sobau C, Wawer Matos J, Zimmerer A. Pericapsular Nerve Group Block Leads to Small but Consistent Reductions in Pain Between 18 and 24 Hours Postoperatively in Hip Arthroscopy for Femoroacetabular Impingement Surgery: A Prospective, Randomized Controlled Clinical Trial. Arthroscopy 2024; 40:373-380. [PMID: 37355181 DOI: 10.1016/j.arthro.2023.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE To investigate whether the use of a pericapsular nerve group (PENG) block would reduce perioperative pain after arthroscopic therapy for femoroacetabular impingement syndrome (FAIS) and to examine opioid requirements and occurrence of postoperative nausea and vomiting (PONV). METHODS Between May 2022 and October 2022, patients (N = 68) undergoing arthroscopic surgery for FAIS were randomly allocated into 2 groups. The first group received an ultrasound-guided PENG preoperatively with 20 mL of 0.375% ropivacaine and standardized postoperative oral medication. The second group received a sham block preoperatively with 20 mL of 0.9% saline and standardized postoperative oral medication. The primary end point was pain scores (visual analog score [VAS], 0-10) during the first 24 hours postoperatively. To quantify clinical significance of outcome achievement for the VAS pain score, the minimal clinically important difference (MCID) was calculated using the half standard deviation method. The incidence of PONV as well as opioid usage (converted to morphine equivalent) within the first 24 hours were secondary outcomes. RESULTS Randomization and permission were successfully obtained from 68 participants. From the fifteenth postoperative hour, the PENG group reported significantly less postoperative pain than the control group (24th postoperative hour: VAS pain PENG group 1.3 ± 0.9 [0-3]; 95% confidence interval {CI} 0.4-1.2 vs the VAS pain control group 2.4 ± 1.6 [0-5]; 95% CI 1.4-4.7; P = .009). The VAS pain score threshold for achieving the MCID at 24 hours postoperative was defined as a decrease of 1.1. 27 patients (79%) in the PENG group and 22 patients (65%) in the control group were able to achieve MCID (P = .009). Opioid dosage and postoperative nausea did not differ significantly between groups (P = .987 and P = .655, respectively). Concomitant complications such as falls, hematomas, or weakened muscles did not occur in either group. CONCLUSIONS According to this study, a PENG block minimally reduced pain after arthroscopic treatment for FAIS between the 18th and 24th postoperative hours. The PENG group achieved significantly more often the pain VAS MCID. However, there was no proof that the PENG group consumed fewer opioids than the control group. Overall, PONV was found at a low and comparable rate. LEVEL OF EVIDENCE Level I, randomized controlled trial.
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Affiliation(s)
| | - Marco M Schneider
- MVZ Praxisklinik Orthopädie Aachen, University of Aachen, Aachen, Germany; University Witten/Herdecke, Witten, Germany
| | - Sebastian Gebhardt
- Department of Orthopaedics, University Medicine Greifswald, Greifswald, Germany
| | | | | | | | - Alexander Zimmerer
- ARCUS Sportklinik, Pforzheim, Germany; Department of Orthopaedics, University Medicine Greifswald, Greifswald, Germany; Orthopädische Klinik Paulinenhilfe, Diakonie-Klinikum Stuttgart, Germany.
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Mou Z, Xiang L, Ni Y. Comparative effectiveness of pericapsular nerve group block versus fascia iliac compartment block on postoperative wound pain management in patients undergoing hip fracture surgery: A systematic review and meta-analysis. Int Wound J 2024; 21:e14637. [PMID: 38332471 PMCID: PMC10853491 DOI: 10.1111/iwj.14637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/17/2023] [Accepted: 12/17/2023] [Indexed: 02/10/2024] Open
Abstract
Hip fracture surgeries are challenging, with postoperative pain management being a critical component of patient care. This systematic review and meta-analysis aimed to compare the effectiveness of Pericapsular nerve group block (PENGB) and fascia iliac compartment block (FICB) in postoperative wound pain management for patients undergoing hip fracture surgery. The study followed the PRISMA guidelines and was structured around the PICO framework. Comprehensive searches were conducted across PubMed, Embase, Web of Science, and the Cochrane Library. Inclusion criteria were limited to RCTs comparing the effectiveness of PENGB and FICB in adult patients undergoing hip fracture surgery. Key outcomes included pain control effectiveness, safety, and complication incidence. The quality of studies was assessed using the Cochrane Collaboration's risk of bias tool. Statistical heterogeneity was evaluated using I2 statistics, and meta-analysis effect values were calculated using random-effects or fixed-effect models, depending on the degree of heterogeneity. The search identified 1095 articles, with 5 studies meeting inclusion criteria. The meta-analysis revealed that PENGB and FICB were comparable in managing postoperative pain and opioid consumption. However, PENGB significantly reduced the incidence of quadriceps muscle weakness (RR = 0.12, p < 0.05) and did not increase the risk of PONV (RR = 1.36, p = 0.51), suggesting its advantage in maintaining motor function without adding to PONV complications. No significant publication bias was detected. PENGB is comparable to FICB in pain and opioid consumption management after hip fracture surgeries. Its significant benefit lies in reducing the incidence of quadriceps muscle weakness, facilitating better postoperative mobility. Additionally, PENGB does not increase the risk of postoperative nausea and vomiting, underlining its suitability for comprehensive postoperative care in hip fracture patients.
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Affiliation(s)
- Zhefei Mou
- Second Department of OrthopaedicsWenzhou City Central HospitalWenzhouChina
| | - Lingping Xiang
- Department of NursingYueqing Panshi Town Health CenterWenzhouChina
| | - Yueping Ni
- Second Department of OrthopaedicsWenzhou City Central HospitalWenzhouChina
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Fusco P, Pascarella G, Stecco C, Blanco R, Forero M, Pawa A, Tulgar S, Strumia A, Remore LM, DE Cassai A, Colantonio LB, Del Buono R, Fattorini F, Sepolvere G, Tedesco M, Petroni GM, Ciaschi W, Crassiti M, Costa F. Factors to consider for fascial plane blocks' success in acute and chronic pain management. Minerva Anestesiol 2024; 90:87-97. [PMID: 38197590 DOI: 10.23736/s0375-9393.23.17866-7] [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: 01/11/2024]
Abstract
The outcome of fascial plane blocks (FPBs) has a certain variability that may depend on many factors, which can be divided into three main categories: operator-related, patient-related and drug-related. Operator-related factors include personal skills, choice of needle and injection modalities. Patient variables include anthropometric features, the type of targeted fascia, anatomical variants, patient positioning, muscle tone and breathing. Ultimately, efficacy, onset, and duration of fascial blocks may be affected by characteristics of the injected solution, including the type of local anesthetic, volume, concentration, pH, temperature and the use of adjuvants. In this article, we investigated all the factors that may influence the outcome of FPBs from a generic perspective, without focusing on any specific technique. Also, we provided suggestions to optimize techniques for everyday practitioners and insights to researchers for future studies.
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Affiliation(s)
- Pierfrancesco Fusco
- Unit of Anesthesia and Intensive Care, SS Filippo e Nicola Hospital, Avezzano, L'Aquila, Italy
| | - Giuseppe Pascarella
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, Padua, Italy
| | - Rafael Blanco
- Unit of Anesthesia and Intensive Care, King's College Hospital Dubai, Abu Dhabi, United Arab Emirates
| | - Mauricio Forero
- Faculty of Anesthesia and Pain Medicine, McMaster University, Hamilton, ON, Canada
| | - Amit Pawa
- Department of Anesthesia and Perioperative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Serkan Tulgar
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Samsun Training and Research Hospital, Samsun University, Samsun, Türkiye
| | - Alessandro Strumia
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
| | - Luigi M Remore
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
| | - Alessandro DE Cassai
- Unit of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy
| | | | - Romualdo Del Buono
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy
| | | | - Giuseppe Sepolvere
- Intensive Care Unit, Department of Anesthesia and Cardiac Surgery, San Michele Hospital, Maddaloni, Caserta, Italy
| | - Mario Tedesco
- Department of Anesthesia, Intensive Care and Pain Therapy, Mater Day Hospital, Bari, Italy
| | - Gian M Petroni
- Unit of Anesthesia and Intensive Care, S. Maria Hospital, Terni, Italy -
| | - Walter Ciaschi
- Unit of Anesthesia and Intensive Care, F. Spaziani Hospital, Frosinone, Italy
| | - Massimiliano Crassiti
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
| | - Fabio Costa
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
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Amin SR, Ahmed F. Comparison between pericapsular nerve group block and fascia iliaca compartment block for perioperative pain control in hip surgeries: A meta-analysis from randomized controlled trials. EGYPTIAN JOURNAL OF ANAESTHESIA 2023. [DOI: 10.1080/11101849.2023.2180540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Affiliation(s)
- Samar Rafik Amin
- Department of Anesthesia, Faculty of Medicine, Benha University, Benha, Egypt
| | - Fatma Ahmed
- Department of Anesthesia, Faculty of Medicine, Benha University, Benha, Egypt
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Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol 2023; 76:575-585. [PMID: 37013389 PMCID: PMC10718628 DOI: 10.4097/kja.23064] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The pericapsular nerve group (PENG) block, quadratus lumborum block (QLB), and intra-articular (IA) local anesthetic injection have been shown to provide effective analgesia in total hip arthroplasty (THA). This randomized study aimed to compare the analgesic efficacy, motor protection, and quality of recovery associated with the PENG block, QLB, and IA injection. METHODS Eighty-nine patients who underwent a unilateral primary THA under spinal anesthesia were randomly assigned to the PENG (n=30), QLB (n=30), or IA (n=29) group. The primary outcome was the numerical rating scale (NRS) score over the first 48 h postoperatively. The secondary outcomes were postoperative opioid consumption, quadriceps and adductor muscle strength, and quality of recovery (QoR-40). RESULTS The dynamic (with movement) NRS scores at 3 and 6 h postoperatively were significantly lower in the PENG and QLB groups compared to the IA group (P = 0.002 and P < 0.001, respectively). The time to first opioid analgesia requirement was longer in the PENG and QLB groups than in the IA group (P = 0.009 and P = 0.016, respectively). A provided better preservation was found in the the PENG group than in the QLB group in terms of quadriceps muscle strength at 3 h postoperatively (P = 0.007) and time to mobilization (P = 0.003). No significant differences in the QoR-40 scores were seen. CONCLUSIONS The PENG and QLB groups showed similar analgesic effects and both showed more effective analgesia 6 h postoperatively than the IA group. All the groups showed similar postoperative quality of recovery.
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Affiliation(s)
- Tayfun Et
- Department of Anesthesiology and Intensive Care Medicine, Karamanoğlu Mehmetbey University Faculty of Medicine, Karaman, Turkey
| | - Muhammet Korkusuz
- Department of Anesthesiology and Intensive Care Medicine, Karamanoğlu Mehmetbey University Faculty of Medicine, Karaman, Turkey
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Jeong JS. What are the best approaches to postoperative pain management after total hip replacement surgery? Korean J Anesthesiol 2023; 76:517-518. [PMID: 38031327 PMCID: PMC10718627 DOI: 10.4097/kja.23774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Ji Seon Jeong
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Aygun H, Tulgar S, Yigit Y, Tasdemir A, Kurt C, Genc C, Bilgin S, Senoğlu N, Koksal E. Effect of ultrasound-guided pericapsular nerve group (PENG) block on pain during patient positioning for central nervous blockade in hip surgery: a randomized controlled trial. BMC Anesthesiol 2023; 23:316. [PMID: 37715173 PMCID: PMC10503118 DOI: 10.1186/s12871-023-02245-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 08/16/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Most patients with hip fractures are elderly patients with comorbidities, and well-managed pain management is associated with positive postoperative outcomes. In recent years, new indications for regional anesthesia techniques have been defined, and they have found more place in clinical practice. Herein we investigate the effect of US-guided PENG block on positioning pain and compare that effect to intravenous opioid in patients undergoing surgery under spinal anesthesia for hip fractures. Additionally, we sought to investigate the effect of PENG block on pain scores, opioid intake, time to first analgesic requirement, and quality of recovery within the first 24 h following surgery. METHODS In this study, patients were divided into the PENG (n = 42) and control group (n = 42) one hour prior to surgery. A team who was blinded to the assigned groups, collected and evaluated all data such as spinal anesthesia positioning pain, postoperative pain, opioid requirement. RESULTS Patients that underwent PENG had statistically significantly lower NRS scores after interventions, immediately before positioning, at positioning and at end of spinal anesthesia. Pain scores during positioning for spinal anesthesia were statistically significantly lower in the PENG group than in the control group (p < 0.001). Total morphine use over the first 24 h was extremely statistically significantly lower in the PENG group (p < 0.001). CONCLUSIONS Positive outcomes of PENG block in patient positioning pain before spinal anesthesia, postoperative pain scores, and morphine consumption are consistent with similar studies. High patient satisfaction in patients who underwent PENG block contributes to the literature. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04871061.
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Affiliation(s)
- Hakan Aygun
- Department of Anesthesiology, Bakircay University Faculty of Medicine Cigli Training and Research Hospital, Izmir, Turkey
| | - Serkan Tulgar
- Department of Anesthesiology, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Yavuz Yigit
- Department of Emergency Medicine, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar.
- Blizard Institute, Queen Mary University, London, United Kingdom.
| | - Ayşe Tasdemir
- Department of Anesthesiology, Bakircay University Faculty of Medicine Cigli Training and Research Hospital, Izmir, Turkey
| | - Cengizhan Kurt
- Department of Orthopedic Surgery, Bakircay University Faculty of Medicine Cigli Training and Research Hospital, Izmir, Turkey
| | - Caner Genc
- Department of Anesthesiology, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Sezgin Bilgin
- Department of Anesthesiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Nimet Senoğlu
- Department of Anesthesiology, Bakircay University Faculty of Medicine Cigli Training and Research Hospital, Izmir, Turkey
| | - Ersin Koksal
- Department of Anesthesiology, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
- Department of Emergency Medicine, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar
- Department of Orthopedic Surgery, Bakircay University Faculty of Medicine Cigli Training and Research Hospital, Izmir, Turkey
- Department of Anesthesiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
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DI Filippo A, Romagnoli S. Nowadays anesthesiologists "look up". Minerva Anestesiol 2023; 89:611-612. [PMID: 36884343 DOI: 10.23736/s0375-9393.23.17225-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- Alessandro DI Filippo
- Division of Anesthesiology and Intensive Care, Department of Health Sciences, University of Florence, Florence, Italy -
| | - Stefano Romagnoli
- Division of Anesthesiology and Intensive Care, Department of Health Sciences, University of Florence, Florence, Italy
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Yang X, Bao L, Gong X, Zhong H. Impacts of Ultrasound-Guided Nerve Block Combined with General Anesthesia with Laryngeal Mask on the Patients with Lower Extremity Fractures. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:3603949. [PMID: 36176970 PMCID: PMC9514925 DOI: 10.1155/2022/3603949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/01/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022]
Abstract
Objective Surgical reduction is the leading approach to patients with lower extremity fractures. The options of anesthetic drugs during surgery are of great significance to postoperative recovery of patients. There is no consensus on the optimum anesthesia method for patients undergoing lower extremity fracture surgery. Our study is aimed at investigating the impacts of nerve block combined with general anesthesia on perioperative outcomes of the patients. Methods In this retrospective study, 48 patients experienced general anesthesia only, and 42 patients received never block combined with general anesthesia. The perioperative hemodynamics was recorded, including mean arterial pressure (MAP), oxygen saturation of blood (SpO2), and heart rate (HR). Visual analogue scale (VAS) and Montreal Cognitive Assessment (MoCA) were carried out to evaluate postoperative pain and cognitive status. Furthermore, adverse reactions and recovery condition were observed between the patients receiving different anesthesia methods. Results At 15 minutes and 30 minutes after anesthesia, as well as 5 minutes after surgery, significant lower MAP was observed in the patients treated with general anesthesia (83.04 ± 8.661, 79.17 ± 9.427, 86.58 ± 8.913) compared to those receiving never block combined with general anesthesia (90.43 ± 4.618, 88.74 ± 6.224, 92.21 ± 4.015) (P < 0.05), and compared with general anesthesia group (68.5 ± 7.05, 69.63 ± 7.956, 72.75 ± 8.446), the combined anesthesia group (73.52 ± 9.451, 74.17 ± 10.13, 77.62 ± 9.768) showed obvious higher HR (P < 0.05). No significant difference in SpO2 was found between the two groups at multiple time points (P > 0.05). As for the score of VAS and MoCA, remarkably lower VAS and higher MoCA at 6 h, 12 h and 24 h after surgery were presented in the combined anesthesia group compared to general anesthesia group (P < 0.05). At 24 h after surgery, the two groups showed normal cognitive function (26.33 ± 0.7244 vs. 28.55 ± 0.7392). Incidence of nausea and vomiting in the combined anesthesia group was lower than that of the general anesthesia group (P < 0.05). The time to out-of-bed activity and hospital stay were shorter in the combined anesthesia group compared with general anesthesia (P < 0.05). Conclusion The application of never block combined with general anesthesia contributed to the stability of hemodynamics, alleviation of postoperative pain and cognitive impairment, along with decrease in adverse reactions and hospital stay in the patients with lower extremity fractures.
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Affiliation(s)
- Xiaoxu Yang
- Anesthesia Operation Center, Chengdu Seventh People's Hospital, China
| | - Lei Bao
- Anesthesia Operation Center, Chengdu Seventh People's Hospital, China
| | - Xue Gong
- Anesthesia Operation Center, Chengdu Seventh People's Hospital, China
| | - Hui Zhong
- Anesthesia Operation Center, Chengdu Seventh People's Hospital, China
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Huda AU, Ghafoor H. The Use of Pericapsular Nerve Group (PENG) Block in Hip Surgeries Is Associated With a Reduction in Opioid Consumption, Less Motor Block, and Better Patient Satisfaction: A Meta-Analysis. Cureus 2022; 14:e28872. [PMID: 36105907 PMCID: PMC9449447 DOI: 10.7759/cureus.28872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 11/05/2022] Open
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Cavaliere F, Allegri M, Apan A, Brazzi L, Carassiti M, Cohen E, DI Marco P, Langeron O, Rossi M, Spieth P, Turnbull D, Weber F. A year in review in Minerva Anestesiologica 2021. Anesthesia, analgesia, and perioperative medicine. Minerva Anestesiol 2022; 88:206-216. [PMID: 35315631 DOI: 10.23736/s0375-9393.22.16429-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Franco Cavaliere
- IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy -
| | - Massimo Allegri
- Unit of Pain Therapy of Column and Athlete, Policlinic of Monza, Monza-Brianza, Italy.,Italian Pain Group, Milan, Italy
| | - Alparslan Apan
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Giresun, Giresun, Turkey
| | - Luca Brazzi
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Massimiliano Carassiti
- Unit of Anesthesia, Intensive Care and Pain Management, Campus Bio-Medico University Hospital, Rome, Italy
| | - Edmond Cohen
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pierangelo DI Marco
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic, and Geriatric Sciences, Faculty of Medicine, Sapienza University, Rome, Italy
| | - Olivier Langeron
- Department of Anesthesia and Intensive Care, Henri Mondor University Hospital, Assistance Publique - Hôpitaux de Paris (APHP), University Paris-Est Créteil (UPEC), Paris, France
| | - Marco Rossi
- IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Peter Spieth
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Dresden, Dresden, Germany
| | - David Turnbull
- Department of Anesthetics and Neuro Critical Care, Royal Hallamshire Hospital, Sheffield, UK
| | - Frank Weber
- Department of Anesthesiology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands
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15
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Hua H, Xu Y, Jiang M, Dai X. Evaluation of Pericapsular Nerve Group (PENG) Block for Analgesic Effect in Elderly Patients with Femoral Neck Fracture Undergoing Hip Arthroplasty. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7452716. [PMID: 35186238 PMCID: PMC8849892 DOI: 10.1155/2022/7452716] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/30/2021] [Accepted: 01/07/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND For evaluating pericapsular nerve group (PENG) block's analgesic effect on elderly patients suffering from femoral neck fracture undergoing hip arthroplasty to provide a basis for optimizing perioperative analgesia in hip arthroplasty. METHODS Forty-eight patients undergoing hip arthroplasty with spinal anesthesia for femoral neck fracture in our hospital were chosen in this study. Based on the random number table method, patients were categorized into the following two groups (n = 24 per group): the hip peripheral nerve group block group (PE group) and the iliac fascia block group (FI group). The fascia iliaca compartment block was used in the FI group, whereas the pericapsular nerve group block in the PE group. When placed in the position for spinal anesthesia (T4), we measured dynamic and static visual analog scale (VAS) scores as well as analgesic satisfaction before blockade (T0), along with at 10 min (T1), 20 min (T2), and 30 min postblockade (T3). Sufentanil dosage and effective analgesic pump press number at 6 h (T5), 12 h (T6), 24 h (T7), and 48 h (T8) postoperatively were recorded. In the meantime, the development of related complications was also recorded. RESULTS Compared with T0, patients in both groups achieved lower static VAS scores at T1-T4 (P < 0.05) and lower dynamic VAS scores at T2-T4 of the FI group (P < 0.05). Relative to the FI group, both static and dynamic VAS scores at T1-T4 were obviously lower in the PE group (P < 0.05), along with increased dynamic analgesic satisfaction (P < 0.05). Weakness of the quadriceps was observed in seven patients in the FI groups (P < 0.05). No delirium, hematoma, puncture site infection, or nerve injury occurred in either group. CONCLUSION The pericapsular nerve group block can provide safe and effective analgesia for elderly patients during the perioperative period of hip arthroplasty, with rapid onset, good analgesic effect, high patient satisfaction, and low complication rate, and is worthy of widespread application. The trial is registered with ChiCTR2100046785.
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Affiliation(s)
- Hao Hua
- Department of Anesthesiology, Wuxi Ninth People's Hospital, Wuxi 214062, China
| | - Yan Xu
- Department of Anesthesiology, Wuxi Ninth People's Hospital, Wuxi 214062, China
| | - MengLu Jiang
- Department of Anesthesiology, Wuxi Ninth People's Hospital, Wuxi 214062, China
| | - Xu Dai
- Department of Anesthesiology, Wuxi Ninth People's Hospital, Wuxi 214062, China
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16
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Pascarella G, Costa F, Del Buono R. Functional recovery after pericapsular nerve group block for hip surgery: a reply. Anaesthesia 2022; 77:359. [DOI: 10.1111/anae.15658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - F. Costa
- Università Campus Bio‐Medico di Roma Rome Italy
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17
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Huang Y, Dong CS, Yu JM. Pericapsular nerve group block in hip arthroplasty. Anaesthesia 2021; 77:358. [PMID: 34919738 DOI: 10.1111/anae.15648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Y Huang
- Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - C-S Dong
- Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - J-M Yu
- Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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18
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Del Buono R, Padua E, Pascarella G, Costa F, Tognù A, Terranova G, Greco F, Fajardo Perez M, Barbara E. Pericapsular hip radiofrequency: future approaches to treat hip chronic pain. Minerva Anestesiol 2021; 87:1393-1394. [PMID: 34527412 DOI: 10.23736/s0375-9393.21.16081-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Romualdo Del Buono
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy
| | - Eleonora Padua
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, Humanitas Mater Domini Hospital, Castellanza, Varese, Italy
| | - Giuseppe Pascarella
- Unit of Anesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University, Rome, Italy -
| | - Fabio Costa
- Unit of Anesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Andrea Tognù
- Department of Anesthesia and Postoperative Intensive Care, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Gaetano Terranova
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy
| | - Federico Greco
- Unit of Diagnostic Imaging, Cittadella della Salute di Lecce, Lecce, Italy
| | | | - Enrico Barbara
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, Humanitas Mater Domini Hospital, Castellanza, Varese, Italy
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19
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Pascarella G, Costa F, Del Buono R, Pulitanò R, Strumia A, Piliego C, De Quattro E, Cataldo R, Agrò FE, Carassiti M. Impact of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial. Anaesthesia 2021; 76:1492-1498. [PMID: 34196965 PMCID: PMC8519088 DOI: 10.1111/anae.15536] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2021] [Indexed: 12/01/2022]
Abstract
The pericapsular nerve group (PENG) block is a novel regional anaesthesia technique that aims to provide hip analgesia with preservation of motor function, although evidence is currently lacking. In this single-centre, observer-masked, randomised controlled trial, patients undergoing total hip arthroplasty received pericapsular nerve group block or no block (control group). Primary outcome measure was maximum pain scores (0-10 numeric rating scale) measured in the first 48 h after surgery. Secondary outcomes included postoperative opioid consumption; patient mobilisation assessments; and length of hospital stay. Sixty patients were randomly allocated equally between groups. The maximum pain score of patients receiving the pericapsular nerve group block was significantly lower than in the control group at all time-points, with a median (IQR [range]) of 2.5 (2.0-3.7 [0-7]) vs. 5.5 (5.0-7.0 [2-8]) at 12 h; 3 (2.0-4.0 [0-7]) vs. 6 (5.0-6.0 [2-8]) at 24 h; and 2.0 (2.0-4.0 [0-5]) vs. 3.0 (2.0-4.7 [0-6]) at 48 h; all p < 0.001. Moreover, the pericapsular nerve group showed a significant reduction in opioid consumption, better range of hip motion and shorter time to ambulation. Although no significant difference in hospital length of stay was detected, our results suggest improved postoperative functional recovery following total hip arthroplasty in patients who received pericapsular nerve group block.
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Affiliation(s)
- G. Pascarella
- Unit of AnesthesiaIntensive Care and Pain ManagementDepartment of MedicineCampus Bio‐Medico UniversityRomeItaly
| | - F. Costa
- Unit of AnesthesiaIntensive Care and Pain ManagementDepartment of MedicineCampus Bio‐Medico UniversityRomeItaly
| | - R. Del Buono
- Unit of AnesthesiaIntensive Care and Pain ManagementASST Gaetano PiniMilanItaly
| | - R. Pulitanò
- Unit of AnesthesiaIntensive Care and Pain ManagementAzienda Ospedaliera San Giovanni AddolorataRomeItaly
| | - A. Strumia
- Unit of AnesthesiaIntensive Care and Pain ManagementDepartment of MedicineCampus Bio‐Medico UniversityRomeItaly
| | - C. Piliego
- Unit of AnesthesiaIntensive Care and Pain ManagementDepartment of MedicineCampus Bio‐Medico UniversityRomeItaly
| | - E. De Quattro
- Unit of AnesthesiaIntensive Care and Pain ManagementDepartment of MedicineCampus Bio‐Medico UniversityRomeItaly
| | - R. Cataldo
- Unit of AnesthesiaIntensive Care and Pain ManagementDepartment of MedicineCampus Bio‐Medico UniversityRomeItaly
| | - F. E. Agrò
- Unit of AnesthesiaIntensive Care and Pain ManagementDepartment of MedicineCampus Bio‐Medico UniversityRomeItaly
| | - M. Carassiti
- Unit of AnesthesiaIntensive Care and Pain ManagementDepartment of MedicineCampus Bio‐Medico UniversityRomeItaly
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20
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Del Buono R, Padua E, Pascarella G, Costa F, Tognù A, Terranova G, Greco F, Fajardo Perez M, Barbara E. Reply to: Tips for pericapsular nerve group (PENG) neurolytic blocks. Minerva Anestesiol 2021; 87:1151-1152. [PMID: 34337929 DOI: 10.23736/s0375-9393.21.16019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Romualdo Del Buono
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milano, Italy
| | - Eleonora Padua
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, Humanitas Mater Domini Hospital, Castellanza, Varese, Italy
| | - Giuseppe Pascarella
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Fabio Costa
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Andrea Tognù
- Department of Anaesthesia and Postoperative Intensive Care, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Gaetano Terranova
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milano, Italy
| | - Federico Greco
- U.O.C. Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Lecce, Italy
| | - Mario Fajardo Perez
- Department of Anesthesia and Chronic Pain Department Hospital Móstoles, Madrid, Spain -
| | - Enrico Barbara
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, Humanitas Mater Domini Hospital, Castellanza, Varese, Italy
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21
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Fusco P, Petroni GM, DI Carlo S, Maggiani C, Marinangeli F, Ciaschi W. PENG radiofrequency and hip chronic pain: is this the new way of the future? Minerva Anestesiol 2021; 87:1391-1393. [PMID: 34337925 DOI: 10.23736/s0375-9393.21.15929-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Pierfrancesco Fusco
- Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L'Aquila, L'Aquila, Italy
| | - Gian Marco Petroni
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy -
| | - Stefano DI Carlo
- Department of Anesthesia and Intensive Care Unit, Mazzini Hospital, Teramo, Italy
| | - Chiara Maggiani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Franco Marinangeli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Walter Ciaschi
- Department of Anesthesia and Intensive Care Unit, Fabrizio Spaziani Hospital of Frosinone, Frosinone, Italy
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22
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Rocha-Romero A, Carvajal G, Lemus A. Tips for pericapsular nerve group (PENG) neurolytic blocks. Minerva Anestesiol 2021; 87:1150-1151. [PMID: 34263583 DOI: 10.23736/s0375-9393.21.15718-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Gabriel Carvajal
- Interventional Pain Unit, Centro Nacional de Control del Dolor y Cuidados Paliativos, San José, Costa Rica
| | - Angel Lemus
- Pain Clinic, Instituto Nacional de Cancerología, Mexico City, Mexico
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23
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Del Buono R, Pascarella G, Padua E, Costa F, Tognù A, Terranova G, Greco F, Fajardo Perez M, Barbara E. PENG block: from standard to unconventional approaches. Minerva Anestesiol 2021; 87:1157-1158. [PMID: 34263587 DOI: 10.23736/s0375-9393.21.15847-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Romualdo Del Buono
- Unit of Anesthesia, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy
| | - Giuseppe Pascarella
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy -
| | - Eleonora Padua
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, Humanitas Mater Domini Hospital, Castellanza, Varese, Italy
| | - Fabio Costa
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Andrea Tognù
- Department of Anaesthesia and Postoperative Intensive Care, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Gaetano Terranova
- Unit of Anesthesia, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy
| | - Federico Greco
- U.O.C. Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Lecce, Italy
| | - Mario Fajardo Perez
- Department of Anesthesia and Chronic Pain Department Hospital Móstoles, Madrid, Spain
| | - Enrico Barbara
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, Humanitas Mater Domini Hospital, Castellanza, Varese, Italy
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24
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Robin F, Newman N, Garneau S, Roy M. PROSPECT guidelines for total hip arthroplasty: a systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia 2021; 76:1424. [PMID: 34251675 DOI: 10.1111/anae.15541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 12/15/2022]
Affiliation(s)
- F Robin
- Centre Hospitalier Universitaire de Montréal, Montréal, QC, Canada
| | - N Newman
- Centre Hospitalier Universitaire de Montréal, Montréal, QC, Canada
| | - S Garneau
- Centre Hospitalier Universitaire de Montréal, Montréal, QC, Canada
| | - M Roy
- Centre Hospitalier Universitaire de Montréal, Montréal, QC, Canada
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25
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Lopez-Lopez D, Casas Reza P, Gestal Vazquez M, Dieguez Garcia P, Lopez Alvarez S. PENG block: better with curvilinear probe. Minerva Anestesiol 2021; 87:1155-1157. [PMID: 34036771 DOI: 10.23736/s0375-9393.21.15781-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- David Lopez-Lopez
- Anesthesiology, postoperative care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain -
| | - Pablo Casas Reza
- Anesthesiology, postoperative care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Maria Gestal Vazquez
- Anesthesiology, postoperative care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Paula Dieguez Garcia
- Anesthesiology, postoperative care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Servando Lopez Alvarez
- Anesthesiology, postoperative care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
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