[Classic high-scoring literature reading] The effect of peripheral nerve block of the hip joint on postoperative analgesia and functional recovery after total hip arthroplasty: a randomized, observer-blind, controlled trial

Translation: Danny Miao Cat Summary: Pericapsular nerve block of the hip joint is a new regional anesthesia technique designed to provide hip analgesia while preserving motor function, although evidence is currently lacking
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In this single-center, observer-blind, randomized, controlled trial, patients undergoing total hip arthroplasty received either hip percapsular nerve block or no block (control group)
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The primary outcome measure was the maximum pain score (0-10 numerical rating scale) measured within the first 48 hours after surgery
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Secondary outcomes included postoperative opioid consumption; patient exercise assessments; and length of hospital stay
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Sixty patients were randomly assigned to each group equally
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Maximum pain scores were significantly lower in patients receiving hip pericapsular nerve blocks than in controls at all time points, with a median (interquartile range [range]) of 2.
5 (2.
0–3.
7 [0] at 12 hours.
–7] vs 5.
5 (5.
0–7.
0 [2–8]); medians (interquartile range [range]) at 24 hours were 3 (2.
0–4.
0 [0–7]) vs 6 (5.
0– 6.
0 [2–8]); median (interquartile range [range]) at 48 hours 2.
0 (2.
0–4.
0 [0–5]) vs 3.
0 (2.
0–4.
7 [0–6]); all p < 0.
001
.

In addition, hip pericapsular nerve block showed a significant reduction in opioid consumption, greater hip range of motion, and shorter recovery time for walking
.

Although no significant difference in length of hospital stay was found between the two groups, our The results showed that patients who received hip capsular nerve block had improved functional recovery after total hip arthroplasty.
Table & Figure 1 PENG performed from lateral to medial
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Once the needle is placed in the plane between the iliopsoas tendon (IPT) and the periosteum and between the anterior inferior iliac spine (AIIS) and the iliopubic eminence (IPE), perform a PENG block by injecting 20 mL of local anesthetic, a local anesthetic The spread is seen under the iliopsoas muscle (IPM)
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Arrow, needle path; dashed blue line, diffusion of local anesthesia; FA, femoral artery; asterisk, needle entry point
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Figure 2 Flow chart of the study Table 1 Baseline characteristics of patients Numbers are mean or numerical Table 2 Study results Numbers are median (interquartile range [range]), number (proportion), or mean (standard deviation)
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Figure 3 Maximum postoperative (numerical rating scale) pain scores reported by the two study groups during the three postoperative time periods
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Numbers have median (bar), interquartile range (box), and range
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* indicates statistical significance (p < 0.
05); PENG indicates peripheral nerve block of hip joint.
Figure 4 Sublingual sufentanil in the first 48 hours after operation
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Black dots indicate the number of sufentanil tablets taken by each patient; PENG indicates the hip joint peripheral nerve block learning card Lateromedial LM from lateral to medial Centerout CO from medial to peripheral Available original