PDF(Pubmed)
Abstract：
Pericapsular nerve group (PENG) block and periarticular injection (PAI) provide motor-sparing analgesia following hip surgery. We hypothesized that PAI offers non-inferior pain relief compared with PENG block in patients undergoing primary total hip arthroplasty (THA). In this randomized trial, 66 patients who underwent primary THA under spinal anesthesia were assigned to the PENG or PAI groups. The primary endpoint was the resting pain score 24 h postoperatively. The secondary endpoints included pain scores at rest and during movement at 6 and 48 h postoperatively, quadriceps strength at 24 h postoperatively, and opioid consumption at 24 and 48 h postoperatively. The mean difference in pain scores at rest between the two groups was 0.30 (95% confidence interval [CI], -0.78 to 1.39) at 24 h postoperatively. The upper 95% CI was lower than the non-inferiority margin, indicating non-inferior performance. No significant between-group differences were observed in the pain scores at 6 and 48 h postoperatively. Additionally, no significant differences in quadriceps strength and opioid consumption were observed between the two groups. The PAI and PENG blocks provided comparable postoperative analgesia during the first 48 h after primary THA. Further investigation is required to determine the optimal PAI technique and local anesthetic mixture.
摘要：
髋关节手术后，囊周神经组（PENG）阻滞和关节周围注射（PAI）可提供运动保留镇痛。我们假设，在接受初次全髋关节置换术（THA）的患者中，与PENG阻滞相比，PAI可以缓解疼痛。在这项随机试验中,66例在脊髓麻醉下接受原发性THA的患者被分配到PENG或PAI组。主要终点是术后24h的静息疼痛评分。次要终点包括术后6小时和48小时休息和运动过程中的疼痛评分，术后24h股四头肌强度，术后24小时和48小时服用阿片类药物。两组之间休息时疼痛评分的平均差异为0.30（95％置信区间[CI]，术后24小时-0.78至1.39）。较高的95%CI低于非劣效性边缘，表明非劣质性能。术后6小时和48小时的疼痛评分没有观察到显著的组间差异。此外,两组的股四头肌力量和阿片类药物用量无显著差异.PAI和PENG阻滞在初次THA后的最初48小时内提供了可比的术后镇痛。需要进一步研究以确定最佳的PAI技术和局部麻醉混合物。
