Analgesic effect of pericapsular nerve group block on elderly patients undergoing hip replacement

Abstract

Background/Aim. Pericapsular nerve group block (PNGB) does not affect the motor nerve while blocking obturator and femoral nerves. The aim of study was to determine the application value of PNGB for elderly hip replacement. Methods. Ninety elderly patients undergoing hip replacement from March 2019 to October 2020 were randomly divided into fascia iliaca compartment block (FICB) and PNGB groups. FICB and PNGB were performed prior to subarachnoid block (SAB), respectively. Their baseline data, operation conditions, incidence of adverse reactions, visual analogue scale (VAS) score, heart rate (HR), mean arterial pressure (MAP), plasma cortisol (COR) and epinephrine (E) were compared. Results. VAS score, E and COR levels in PNGB group were lower than those in FICB group at time points T2-T4 (T2: 10 min after nerve block; T3: at position changing; T4: after position changing) (p<0.001). There were no significant differences in HR and MAP between the two groups at any time point (p >0.05). In PNGB group, the ultrasonic imaging time was shorter, the time point of pressing patient-controlled analgesia (PCA) for the first time was later, and the numbers of pressing PCA were fewer than those of FICB group (p <0.001). No local anesthetic poisoning occurred after nerve block, and no hematoma at the puncture site, nerve injury, nausea and vomiting, dizziness and delirium were found.Conclusion. Both FICB and PNGB prior to Swere highly safe for elderly hip replacement, but PNGB has shorter ultrasonic imaging time, better analgesic effect and milder oxidative stress, so it is worth applicating it clinically.