PDF(Pubmed)
Abstract：
UNASSIGNED: Local infiltration analgesia (LIA) has been advocated for the pain management after total hip arthroplasty (THA). The analgesic benefits of an added pericapsular nerve group (PENG) block remain questionable.
UNASSIGNED: This randomized, single-blind trial enrolled patients undergoing elective THA under general anaesthesia and standardized postoperative analgesia. Patients were allocated to receive either a PENG block (20 mL of ropivacaine 0.475 %) combined with intraoperative LIA (PENG + LIA group, n = 32), or intraoperative LIA alone (LIA group, n = 32). The primary outcome was oral morphine equivalent (OME) consumption at day 1. Secondary outcomes were: pain scores at post anaesthesia care unit (PACU) discharge and on day 2, times for the Timed to Up and Go (TUG) test and measurement of adductor strength on day 1, and patients\' satisfaction using the EVAN-G questionnaire.
UNASSIGNED: Compared with LIA alone, PENG + LIA resulted in similar OME consumption on day 1 (78 [51-91.5] mg vs 58 [30-80] mg respectively, median difference (95%CI) of -17 (-34 to 1) mg, p = 0.09). Pain scores and morphine consumption were not different between groups at any time point. TUG and thigh adduction tests were similar between LIA and PENG + LIA groups (respectively 35 [25-48.5] vs 31.5 [19.5-46.5] sec, p = 0.39; and 105 [85-150] vs 100 [80-125] mmHg, p = 0.61). No difference in the patients\' satisfaction was found.
UNASSIGNED: The addition of a PENG block to large-volume LIA did not significantly improve the analgesia for elective THA in the setting of an adequate basic postoperative analgesia regimen. The results of the lower limb functional tests confirmed the PENG block to be motor-sparing.
UNASSIGNED: This randomized, single-blind trial enrolled patients undergoing elective THA under general anaesthesia and standardized postoperative analgesia. Patients were allocated to receive either a PENG block (20 mL of ropivacaine 0.475 %) combined with intraoperative LIA (PENG + LIA group, n = 32), or intraoperative LIA alone (LIA group, n = 32). The primary outcome was oral morphine equivalent (OME) consumption at day 1. Secondary outcomes were: pain scores at post anaesthesia care unit (PACU) discharge and on day 2, times for the Timed to Up and Go (TUG) test and measurement of adductor strength on day 1, and patients\' satisfaction using the EVAN-G questionnaire.
UNASSIGNED: Compared with LIA alone, PENG + LIA resulted in similar OME consumption on day 1 (78 [51-91.5] mg vs 58 [30-80] mg respectively, median difference (95%CI) of -17 (-34 to 1) mg, p = 0.09). Pain scores and morphine consumption were not different between groups at any time point. TUG and thigh adduction tests were similar between LIA and PENG + LIA groups (respectively 35 [25-48.5] vs 31.5 [19.5-46.5] sec, p = 0.39; and 105 [85-150] vs 100 [80-125] mmHg, p = 0.61). No difference in the patients\' satisfaction was found.
UNASSIGNED: The addition of a PENG block to large-volume LIA did not significantly improve the analgesia for elective THA in the setting of an adequate basic postoperative analgesia regimen. The results of the lower limb functional tests confirmed the PENG block to be motor-sparing.
摘要：
■局部浸润镇痛（LIA）已被提倡用于全髋关节置换术（THA）后的疼痛管理。增加的囊周围神经组（PENG）阻滞的镇痛益处仍然值得怀疑。
■这是随机的，单盲试验纳入了在全身麻醉和标准化术后镇痛下接受择期THA的患者.患者被分配接受PENG阻滞（20mL罗哌卡因0.475％）联合术中LIA（PENGLIA组，n=32),或单独术中LIA(LIA组，n=32)。主要结果是第1天的口服吗啡当量（OME）消耗。次要结果是：麻醉后监护病房（PACU）出院时和第2天的疼痛评分，第1天的定时向上（TUG）测试和内收肌强度测量的次数，以及使用EVAN-G问卷的患者满意度。
■与单独的LIA相比，PENG+LIA导致第1天的OME消耗相似（分别为78[51-91.5]mg和58[30-80]mg，中位数差异（95CI）为-17（-34至1）mg，p=0.09)。在任何时间点，两组之间的疼痛评分和吗啡消耗量均无差异。LIA和PENG+LIA组的TUG和大腿内收试验相似(分别为35[25-48.5]vs31.5[19.5-46.5]秒,p=0.39；105[85-150]对100[80-125]mmHg，p=0.61）。患者的满意度没有差异。
■在足够的基础术后镇痛方案下，在大容量LIA中添加PENG阻滞并没有显着改善选择性THA的镇痛效果。下肢功能测试的结果证实PENG阻滞是运动保护的。
■这是随机的，单盲试验纳入了在全身麻醉和标准化术后镇痛下接受择期THA的患者.患者被分配接受PENG阻滞（20mL罗哌卡因0.475％）联合术中LIA（PENGLIA组，n=32),或单独术中LIA(LIA组，n=32)。主要结果是第1天的口服吗啡当量（OME）消耗。次要结果是：麻醉后监护病房（PACU）出院时和第2天的疼痛评分，第1天的定时向上（TUG）测试和内收肌强度测量的次数，以及使用EVAN-G问卷的患者满意度。
■与单独的LIA相比，PENG+LIA导致第1天的OME消耗相似（分别为78[51-91.5]mg和58[30-80]mg，中位数差异（95CI）为-17（-34至1）mg，p=0.09)。在任何时间点，两组之间的疼痛评分和吗啡消耗量均无差异。LIA和PENG+LIA组的TUG和大腿内收试验相似(分别为35[25-48.5]vs31.5[19.5-46.5]秒,p=0.39；105[85-150]对100[80-125]mmHg，p=0.61）。患者的满意度没有差异。
■在足够的基础术后镇痛方案下，在大容量LIA中添加PENG阻滞并没有显着改善选择性THA的镇痛效果。下肢功能测试的结果证实PENG阻滞是运动保护的。
