原发性全髋关节置换术中囊周神经组阻滞与关节内和腰方肌阻滞的比较:一项随机对照试验。

IF 4.2 4区 医学 Q1 ANESTHESIOLOGY
Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-04-04 DOI:10.4097/kja.23064
Tayfun Et, Muhammet Korkusuz
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引用次数: 0

摘要

背景:在全髋关节置换术(THA)中,囊周神经组(PENG)阻滞、腰方肌阻滞(QLB)和关节内局麻注射已被证明能提供有效的镇痛。这项随机研究旨在比较PENG阻滞、QLB和IA注射的镇痛效果、运动保护和恢复质量。方法:89例在脊髓麻醉下行单侧原发性THA的患者随机分为PENG组(n=30)、QLB组(n=30)和IA组(n=29)。主要观察指标为术后48小时的数值评定量表(NRS)评分。次要结果是术后阿片类药物消耗、股四头肌和内收肌力量以及恢复质量(QoR-40)。结果:与IA组相比,PENG组和QLB组术后3、6 h动态(运动)NRS评分显著降低(P = 0.002和P < 0.001)。与IA组相比,PENG组和QLB组首次需要阿片类药物镇痛的时间更长(P = 0.009和P = 0.016)。在术后3小时的股四头肌力量(P = 0.007)和活动时间(P = 0.003)方面,PENG组比QLB组提供了更好的保存。QoR-40评分无显著差异。结论:PENG组与QLB组镇痛效果相近,且术后6 h镇痛效果均优于IA组。各组术后恢复质量相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial.

Background: The pericapsular nerve group (PENG) block, quadratus lumborum block (QLB), and intra-articular (IA) local anesthetic injection have been shown to provide effective analgesia in total hip arthroplasty (THA). This randomized study aimed to compare the analgesic efficacy, motor protection, and quality of recovery associated with the PENG block, QLB, and IA injection.

Methods: Eighty-nine patients who underwent a unilateral primary THA under spinal anesthesia were randomly assigned to the PENG (n=30), QLB (n=30), or IA (n=29) group. The primary outcome was the numerical rating scale (NRS) score over the first 48 h postoperatively. The secondary outcomes were postoperative opioid consumption, quadriceps and adductor muscle strength, and quality of recovery (QoR-40).

Results: The dynamic (with movement) NRS scores at 3 and 6 h postoperatively were significantly lower in the PENG and QLB groups compared to the IA group (P = 0.002 and P < 0.001, respectively). The time to first opioid analgesia requirement was longer in the PENG and QLB groups than in the IA group (P = 0.009 and P = 0.016, respectively). A provided better preservation was found in the the PENG group than in the QLB group in terms of quadriceps muscle strength at 3 h postoperatively (P = 0.007) and time to mobilization (P = 0.003). No significant differences in the QoR-40 scores were seen.

Conclusions: The PENG and QLB groups showed similar analgesic effects and both showed more effective analgesia 6 h postoperatively than the IA group. All the groups showed similar postoperative quality of recovery.

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来源期刊
CiteScore
6.20
自引率
6.90%
发文量
84
审稿时长
16 weeks
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