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Abstract：
Background and Objectives: Local infiltration analgesia (LIA) represents a potential approach to reducing pain in patients undergoing total hip arthroplasty (THA). The pericapsular nerve group (PENG) block also provides adequate analgesia for fractures and THA. As most hip surgeries use a lateral incision, affecting the cutaneous supply by branches of the lateral femoral cutaneous nerve (LFCN), the LFCN block can contribute to postoperative analgesia. However, no studies have investigated the effectiveness of supplemental PENG block combined with LFCN block in patients undergoing LIA after hip fracture surgery. Our study aimed to assess the effectiveness of PENG combined with LFCN block following hip fracture surgery in patients who underwent LIA. Materials and Methods: Forty-six patients were randomly assigned to LIA or PENG + LFCN + LIA groups. The primary outcome was the pain score at rest and during movement at 2, 6, 12, 24, and 48 h postoperatively. The total opioid dose for postoperative analgesia was also measured at the same time points. Secondary outcomes included postoperative cognitive function assessment. Results: The median pain scores at rest and during movement were lower in the PENG + LFCN + LIA group throughout the study periods compared to the LIA group, except at 2 h (at rest) and 48 h (during movement) after surgery. The total fentanyl dose was lower in the PENG + LFCN + LIA group at all time points after surgery when compared to the LIA group. Postoperative delirium incidence and the median abbreviated mental test scores were not significantly different between the two groups. Conclusions: The combination of PENG and LFCN blocks may contribute to enhanced recovery for patients undergoing LIA after hip fracture surgery. However, further well-controlled research is necessary to determine the effectiveness of supplemental PENG combined with LFCN block in addressing cognitive deficits in these patients.
摘要：
背景和目的：局部浸润镇痛（LIA）是减轻全髋关节置换术（THA）患者疼痛的潜在方法。囊周神经组（PENG）阻滞还为骨折和THA提供了足够的镇痛作用。由于大多数髋部手术都使用外侧切口，通过股外侧皮神经（LFCN）的分支影响皮肤供应，LFCN阻滞有助于术后镇痛。然而,没有研究调查补充PENG阻滞联合LFCN阻滞对髋部骨折术后LIA患者的有效性.我们的研究旨在评估PENG联合LFCN阻滞在接受LIA的髋部骨折手术后的有效性。材料与方法：46例患者随机分为LIA或PENG+LFCN+LIA组。主要结果是术后2、6、12、24和48h休息和运动过程中的疼痛评分。还在相同时间点测量了术后镇痛的总阿片类剂量。次要结果包括术后认知功能评估。结果：在整个研究期间，PENG+LFCN+LIA组在休息和运动时的疼痛评分中位数低于LIA组，手术后2小时（休息时）和48小时（运动时）除外。与LIA组相比,PENG+LFCN+LIA组在手术后的所有时间点的总芬太尼剂量较低。两组术后谵妄发生率和中位缩略心理测验评分无显著差异。结论：PENG和LFCN阻滞的组合可能有助于髋部骨折术后LIA患者的康复。然而,需要进一步的良好对照研究来确定补充PENG联合LFCN阻滞在解决这些患者认知缺陷方面的有效性.
