A randomized controlled study of pericapsular nerve group block (PENG block) plus lateral femoral cutaneous nerve block vs patient-controlled intravenous analgesia for postoperative analgesia after hip replacement surgery | [Anaesthesia, Pain and Intensive Care • 2024]

Author(s):

1. TRAN Van Dang: Can Tho University of Medicine and Pharmacy,Can Tho,Vietnam

2. Nguyen Do Hung: E University Hospital,Hanoi,Vietnam

3. Nguyen Xuan Quang: E University Hospital,Hanoi,Vietnam

4. Tu Huu Nguyen: Hanoi Medical University, Hanoi Medical University Hospital,Hanoi,Vietnam

5. Duc Viet Tran: Hanoi Medical University Hospital,Hanoi,Vietnam

6. VU Hoang Phuong: Hanoi Medical University, Hanoi Medical University Hospital,Hanoi,Vietnam

Abstract:

Background: Postoperative pain often remains troublesome for the patients, if not adequately managed. Various modalities have been tried to keep the patient pain free. Regional nerve blocks under ultrasound guidance have recently gained much popularity. We aimed to compare the pain relief outcomes after hip replacement surgery by continuous Pericapsular Nerve Group Block (PENG Block) in combination with lateral femoral cutaneous nerve (LFCN) block under the guidance of ultrasound versus patient-controlled intravenous analgesia (PCA). Methodology: Sixty patients, who underwent hip surgery at E University Hospital, Hanoi, Vietnam, from August 2021 to August 2022, were randomly allocated to one of the two groups: group of patients with pain relief with PENG block in combination with LFCN block (PENG group) and the group of patients with patient-controlled intravenous analgesia (PCA group). Outcomes regarding clinical parameters and pain scores on Visual Analogue Scale (VAS), from the initiation of the blocks or the PCA (H0) to 72 h (H72) were recorded and compared. Results: Sixty patients were included in this study. The average VAS scores at rest in both groups was at low pain level (VAS < 4). The average VAS score in both of the groups at most of the time of the study did not have a statistically significant difference. The VAS on movement at the time points H18, H21, H24, H30, H36, H48, H72 of the PENG group was lower than that of the PCA group and the difference was statistically significant between the two groups (P < 0.05). The rate of vomiting/nausea of patients in the PCA group was significantly higher than in the PENG group (P = 0.006). Conclusion: Pericapsular nerve block combined with lateral femoral cutaneous nerve block offers prolonged pain relief when compared with traditional patient-controlled intravenous analgesia in postoperative pain relief after hip replacement, and is associated with lower frequency of vomiting/nausea.

Page(s): 323-328

DOI: 10.35975/apic.v28i2.2441

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 28, Issue: 2, Year: 2024

Keywords:

Side effects , Multimodal analgesia , Lateral femoral cutaneous nerve , Pericapsular nerve group block , Patientcontrolled analgesia , Hip Replacement , Ultrasoundguided analgesia

References:

[1] .2022 .. , : .

[2] Ferguson RJ,Palmer AJ,Taylor A,Porter ML,Malchau H,GlynJones S H .2018 .Hip replacement. Lancet, 6736(18) : 31777-71.

[3] .2011 .Painful hip arthroplasty: definition. Clin Cases Miner Bone Metab, 22461810(2) : 19-22.

[4] YaDeau JT,Tedore T,Goytizolo EA,Kim DH,Green DS,Westrick A,PMID D .2012 .Lumbar plexus blockade reduces pain after hip arthroscopy: a prospective randomized controlled trial. Anesth Analg, 10(4) : 968-72.

[5] .2009 .. , 7094(09) : 70078-9.

[6] Singelyn FJ,Ferrant T,Malisse MF,Joris D. .2005 .Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous femoral nerve sheath block on rehabilitation after unilateral total-hip arthroplasty. Reg Anesth Pain Med, 05(5) : 452-7.

[7] .2021 .. , 46(5) : 102315-403.

[8] .2010 .. , 21526668(6) : 827-32.

[9] Rasouli MR,Viscusi ER .2017 .Adductor Canal Block for Knee Surgeries: An Emerging Analgesic Technique. Arch Bone Jt Surg, 28656158(3) : 131-2.

Citations

Downloads

Views