The Analgesic Effects of Preemptive Ultrasound-Guided Pericapsular Nerve Group Block in Comparison with Erector Spinae Plane Block in Elderly Undergoing Hip Arthroplasty: A Randomized Controlled Trial.

Q2 Medicine
Anesthesiology and Pain Medicine Pub Date : 2023-09-04 eCollection Date: 2023-10-01 DOI:10.5812/aapm-138623
Marwa Mohamed Medhat, Alshaimaa Abdel Fattah Kamel, Dina Abdelhameed Elsadek Salem, Sherif A Alagamy, Heba M Fathi
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Abstract

Background: Perioperative pain management strategies in the elderly undergoing hip arthroplasty need special and safe preemptive care.

Objectives: The primary aim of this study was to compare the analgesic effects of preemptive ultrasound-guided pericapsular nerve group (PENG) block and lumbar erector spinae plane block (L-ESPB) in the elderly undergoing hip arthroplasty. The time to the first postoperative rescue analgesia was measured. The secondary aim was to assess the ease of spinal positioning (EOSP), onset of sensory block, block performance time, and patient satisfaction.

Methods: Before positioning for spinal anesthesia, 69 elderly patients undergoing hip arthroplasty were randomized into three groups (n = 23 per group). The first intervention group received ultrasound-guided PENG block with 20 mL bupivacaine 0.25%; the second intervention group received ultrasound-guided L-ESPB using the same dose of bupivacaine. In the control group, patients received spinal anesthesia without any block.

Results: The time to first postoperative rescue analgesic (morphine) was significantly prolonged in the PENG group (13.3 ± 3.5 h) compared to the L-ESPB (9.5 ± 2.3 h) and control (2.6 ± 0.4 h) groups. The EOSP score was significantly higher in the PENG group compared to the L-ESPB and control groups (P < 0.001). The block performance time and oneset of the sensory block were significantly shorter in the PENG group compared to the L-ESPB group. The highest patient satisfaction scores were observed in the PENG group.

Conclusions: Preemptive pericapsular nerve group block postponed the need for postoperative analgesia and eased spinal positioning compared to L-ESPB in the elderly undergoing hip arthroplasty.

超声引导下囊包膜神经群阻滞与竖脊肌平面阻滞在老年髋关节置换术中的镇痛效果:一项随机对照试验
背景:老年人髋关节置换术围手术期疼痛管理策略需要特殊和安全的先发制人的护理。目的:本研究的主要目的是比较超声引导下囊包膜神经组(PENG)阻滞和腰椎竖立者脊柱平面阻滞(L-ESPB)在老年髋关节置换术中的镇痛效果。观察到术后第一次抢救镇痛的时间。第二个目的是评估脊柱定位的容易程度(EOSP),感觉阻滞的发生,阻滞的表现时间和患者满意度。方法:69例老年人工髋关节置换术患者在脊柱麻醉前定位,随机分为3组(每组23例)。第一干预组采用超声引导下用0.25%布比卡因20 mL进行彭阻滞;第二干预组使用相同剂量的布比卡因进行超声引导下的L-ESPB。对照组患者行脊髓麻醉,无阻滞。结果:与L-ESPB组(9.5±2.3 h)和对照组(2.6±0.4 h)相比,PENG组(13.3±3.5 h)术后第一次抢救镇痛(吗啡)时间明显延长。与L-ESPB组和对照组相比,PENG组EOSP评分显著高于L-ESPB组(P < 0.001)。与L-ESPB组相比,PENG组阻滞表现时间和感觉阻滞开始时间显著缩短。彭组患者满意度得分最高。结论:与L-ESPB相比,在老年髋关节置换术中,先发制人的囊周神经群阻滞延迟了术后镇痛的需要,缓解了脊柱定位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Anesthesiology and Pain Medicine
Anesthesiology and Pain Medicine Medicine-Anesthesiology and Pain Medicine
CiteScore
4.60
自引率
0.00%
发文量
49
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