A modified hip pericapsular nerve block on postoperative pain and functional outcomes after total hip arthroplasty: a prospective, double-blind, randomized controlled study.

Abstract

Background: This study aimed to explore the efficacy and safety of the hip pericapsular nerve block (hip-PNB), which combines the anterior pericapsular nerve group (PENG) and posterior pericapsular deep-gluteal (PPD) blocks, on postoperative pain and functional outcomes after total hip arthroplasty (THA) via the posterolateral approach.

Methods: Seventy patients undergoing THA were allocated to either the nerve block group (Group N, hip-PNB + sham local infiltration analgesia [LIA]) or the control group (Group C, sham hip-PNB + LIA). The primary outcome was cumulative morphine consumption in the first 24 h postoperatively. Secondary outcomes included visual analog scale pain scores at rest and during movement postoperatively, time to first rescue analgesia, cumulative morphine consumption during hospitalization, opioid consumption during surgery, postoperative recovery, and postoperative complications.

Results: Compared with Group C, Group N consumed significantly less morphine in the first 24 h (10 [0-10] mg vs. 10 [10-20] mg; P < 0.001) and throughout hospitalization (10 [0-20] mg vs. 20 [20-30] mg; P < 0.001) and had less opioid consumption perioperatively. Group N also had significantly lower pain scores at rest and during movement in the first 24 h, required rescue analgesia later, and had faster recovery postoperatively than Group C. No significant intergroup differences were observed in quadriceps muscle strength or postoperative complication rates.

Conclusions: Compared to LIA, Hip-PNB has better postoperative analgesia and enhances recovery in patients undergoing THA.