一项前瞻性随机对照临床试验：股神经阻滞与囊周神经阻滞在老年股骨粗隆间骨折预防性镇痛中的比较

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-29 DOI:10.1016/j.jor.2025.07.026

Ashuthosh Kumar Gupta , Karthik Ramachandran , Kartik Sonawane , Ajoy Prasad Shetty , Palanichamy Gurumoorthi , Jagannathan Balavenkatasubramaniam , Shanmuganathan Rajasekaran

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引用次数: 0

摘要

目的局部阻滞如股神经阻滞（FNB）和包膜神经组阻滞（PENG）是髋关节周围骨折术后常用的止痛方法。本研究比较了PENG阻滞与FNB治疗转子间骨折的镇痛效果。方法本随机对照临床试验纳入65 ~ 80岁股骨粗隆间骨折患者，计划行闭合复位和头髓内钉固定。将患者随机分为两组：第一组（n = 40）术前接受FNB治疗，第二组（n = 40）术前接受PENG阻滞治疗。结果测量为术后VAS评分、阿片类药物总消耗量、股四头肌力量和活动时间。结果两组患者术后疼痛均明显减轻。FNB组和PENG组在6、12、18、24、36和48 h时的VAS评分无显著差异。PENG组在12 h时股四头肌力量保存较好(p <；0.05)， 60 h时两组间无显著差异。前48 h两组的阿片类药物总消耗量相似（PENG组为8.03吗啡毫当量（MME）， FNB组为7.07吗啡毫当量（MME）， p值为0.05）。结论peng阻滞与FNB对老年股骨粗隆间骨折患者的疼痛缓解和阿片类药物需求的减少效果相同。然而，PENG组在12 h时表现出更好的股四头肌力量保存。

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Comparison between femoral nerve block and pericapsular nerve group block as preemptive analgesia in geriatric intertrochanteric fractures: A prospective randomised controlled clinical trial

Purpose

Regional blocks such as femoral nerve block (FNB) and Pericapsular nerve group (PENG) block are frequently used for postoperative pain relief in fractures around the hip joint. This study compares the analgesic efficacy of PENG block with FNB in the management of intertrochanteric fractures.

Methods

This randomised controlled clinical trial included patients aged 65–80 years with intertrochanteric fractures who were planned for closed reduction and cephalomedullary nailing. The patients were randomised into two groups: Group 1 (n = 40) received FNB, while Group 2 (n = 40) received PENG block preoperatively. The outcome measures were postoperative VAS score, total opioid consumption, quadriceps power, and duration of mobilisation.

Results

There was a significant reduction in postoperative pain in both groups. A comparison between the FNB and PENG blocks showed no significant difference in VAS scores at 6, 12, 18, 24, 36, and 48 h. The PENG group had better quadriceps strength preservation at 12 h (p < 0.05), with no significant difference between the two groups at 60 h. The total opioid consumption in the first 48 h was similar in both groups (8.03 Morphine milliequivalents (MME) in PENG and 7.07 MME in the FNB group, p-value >0.05).

Conclusion

PENG block and FNB are equally effective in pain relief and in reducing opioid requirements in elderly patients with intertrochanteric fractures. However, the PENG group showed better preservation of quadriceps strength at 12 h.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.