Abstract
Background For evaluating pericapsular nerve group (PENG) block's analgesic effect on elderly patients suffering from femoral neck fracture undergoing hip arthroplasty to provide a basis for optimizing perioperative analgesia in hip arthroplasty. Methods Forty-eight patients undergoing hip arthroplasty with spinal anesthesia for femoral neck fracture in our hospital were chosen in this study. Based on the random number table method, patients were categorized into the following two groups (n = 24 per group): the hip peripheral nerve group block group (PE group) and the iliac fascia block group (FI group). The fascia iliaca compartment block was used in the FI group, whereas the pericapsular nerve group block in the PE group. When placed in the position for spinal anesthesia (T4), we measured dynamic and static visual analog scale (VAS) scores as well as analgesic satisfaction before blockade (T0), along with at 10 min (T1), 20 min (T2), and 30 min postblockade (T3). Sufentanil dosage and effective analgesic pump press number at 6 h (T5), 12 h (T6), 24 h (T7), and 48 h (T8) postoperatively were recorded. In the meantime, the development of related complications was also recorded. Results Compared with T0, patients in both groups achieved lower static VAS scores at T1–T4 (P < 0.05) and lower dynamic VAS scores at T2–T4 of the FI group (P < 0.05). Relative to the FI group, both static and dynamic VAS scores at T1–T4 were obviously lower in the PE group (P < 0.05), along with increased dynamic analgesic satisfaction (P < 0.05). Weakness of the quadriceps was observed in seven patients in the FI groups (P < 0.05). No delirium, hematoma, puncture site infection, or nerve injury occurred in either group. Conclusion The pericapsular nerve group block can provide safe and effective analgesia for elderly patients during the perioperative period of hip arthroplasty, with rapid onset, good analgesic effect, high patient satisfaction, and low complication rate, and is worthy of widespread application. The trial is registered with ChiCTR2100046785.
Highlights
For evaluating pericapsular nerve group (PENG) block’s analgesic effect on elderly patients suffering from femoral neck fracture undergoing hip arthroplasty to provide a basis for optimizing perioperative analgesia in hip arthroplasty
Hip arthroplasty is the main surgical treatment for femoral neck fractures in the elderly, and given China’s aging population, hip arthroplasty is frequently performed in clinical practice. [1, 2] Numerous studies have shown that hip arthroplasty can cause severe pain in the perioperative period, which can lead to a series of related complications, which increases the perioperative risk and is detrimental to the long-term prognosis of patients. erefore, an optimal perioperative analgesia can greatly facilitate the patient’s postoperative recovery. [3, 4] e fascia iliaca compartment block is often used to relieve patients’
Spinal anesthesia is preferred as the anesthetic method for hip arthroplasty in elderly patients, and the commonly used analgesic method is fascia iliaca compartment block (FICB), which is easier to operate and has better analgesic effect than intravenous fentanyl and nonsteroidal analgesics alone
Summary
Hip arthroplasty is the main surgical treatment for femoral neck fractures in the elderly, and given China’s aging population, hip arthroplasty is frequently performed in clinical practice. [1, 2] Numerous studies have shown that hip arthroplasty can cause severe pain in the perioperative period, which can lead to a series of related complications, which increases the perioperative risk and is detrimental to the long-term prognosis of patients. erefore, an optimal perioperative analgesia can greatly facilitate the patient’s postoperative recovery. [3, 4] e fascia iliaca compartment block is often used to relieve patients’. [11] A distinct advantage of the PENG block is the supine position, which is especially important for patients with chronic pain or acute hip fractures E current work compared the analgesic effect and safety of fascia iliaca compartment block (FICB) and PENG block in elderly patients undergoing femoral neck fractures during the perioperative period and provided a reference for clinical application. Patients were admitted to the operating room with routine cardiac monitoring and open intravenous access Patients in both groups were located in the supine position, and ultrasound-guided puncture was performed by the same experienced anesthesiologist. Methods of operation in the PE group were as follows: patients were operated with a curvilinear low-frequency ultrasound probe (SonoSite Edge II, frequency: 2–5 MHz) placed vertically within transverse plane where anterior inferior iliac spine is located. Weakness of the quadriceps was observed in seven patients in the FI group (P < 0.05, Table 3)
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