Does PENG-LFCN Block Have Significant Optimization Effect?
Abstract
Objective: To compare the clinical effects of pericapsular hip nerve block (PENG) combined with lateral femoral cutaneous nerve block (LFCN) and hourglass iliac fascial space block (FICB) in total hip replacement (THR) in elderly patients. Method: Sixty elderly ASAⅡorⅢ patients of both sexes, aged 65-85 yrs., with BMI 18-25 kg/m2, were divided into two groups by random number table method: FICB (group F, n=30) and PENG-LFCN (group PL, n=30). FICB with hourglass method was performed under ultrasound guidance in group F, and PENG-LFCN block was performed in group PL. After confirming the efficacy of nerve block，total intravenous anesthesia was carried out to maintain bispectrality index values 40-60.Postoperative sufentanil and tropisetron were used for PCIA. The consumption of propofol ,opioid analgesics during operation，postoperative recovery, and the incidence of quadricep muscle weakness at 1h after surgery，the incidence of adverse reactions and the satisfaction score of postoperative recovery and the occurrence of adverse reactions within 48h after surgery was recorded. Result: There were no significant differences in intraoperative medication, postoperative recovery and postoperative adverse reactions between the two groups, but the incidence of postoperative quadriceps muscle weakness in the group PL was less than that in the F group at the same time (P<0.05), and the postoperative recovery satisfaction score of the group PL was significantly higher than that of the group F. Conclusion: Fewer drugs resulted in higher postoperative recovery satisfaction. PENG-LFCN block is worth promoting.
References
Yao Yunchao. A comparative study of the early efficacy of two approaches in total hip arthroplasty based on the concept of rapid rehabilitation surgery [D]. Zunyi Medical University,2020.
Acharya, U. and R. Lamsal, Pericapsular Nerve Group Block: An Excellent Option for Analgesia for Positional Pain in Hip Fractures. Case reports in anesthesiology, 2020. 2020: p. 1830136.
Remily, E., et al., The pericapsular nerve group block: a step towards outpatient total hip arthroplasty? Hip international: the journal of clinical and experimental research on hip pathology and therapy, 2020: p. 1120700020978211.
Xie Yingchao, Wang Meirong, Li Zhipeng, et al. Effects of ultrasound-guided pericapsular nerve plexus block on pain in senile patients with femoral neck fracture [J]. Journal of Clinical Anesthesiology,2020,36(8):754-758.
Singh H, Jones D. Hourglass-Pattern Recognition Simplifies Fascia Iliaca Compartment Block[J]. Regional anesthesia and pain medicine, 2013, 38(5):467-468.
Luftig, J., et al., A new frontier in pelvic fracture pain control in the ED: Successful use of the pericapsular nerve group (PENG) block. The American journal of emergency medicine, 2020.
Neal JM. Assessment of lower extremity nerve block: reprise of the Four P's acronym. [J]. Reg Anesth Pain Med, 2002, 27(6):618-20. DOI:10.1053/rapm. 2002. 37411.
Kukreja, P., et al., A Retrospective Case Series of Pericapsular Nerve Group (PENG) Block for Primary Versus Revision Total Hip Arthroplasty Analgesia. Cureus, 2020. 12(5): p. e8200.
Copyright (c) 2021 Dan Qiao, Rui Xia, Ying Wang, Yongle Li, Yifan Xue
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors contributing to this journal agree to publish their articles under the Creative Commons Attribution-Noncommercial 4.0 International License, allowing third parties to share their work (copy, distribute, transmit) and to adapt it, under the condition that the authors are given credit, that the work is not used for commercial purposes, and that in the event of reuse or distribution, the terms of this license are made clear. With this license, the authors hold the copyright without restrictions and are allowed to retain publishing rights without restrictions as long as this journal is the original publisher of the articles.
