Combined Pericapsular Nerve Group Block and Intrapelvic Lateral Femoral Cutaneous Nerve Block Is Associated With Decreased Opioid Consumption After Hip Arthroscopy: A Retrospective Cohort Study
摘要:
Introduction: Ambulatory hip arthroscopies are associated with moderate-to-severe pain often requiring opioid analgesia. Novel motor-sparing blocks, the pericapsular nerve group (PENG) and lateral femoral cutaneous nerve (LFCN) block, have shown efficacy in hip surgery.Purpose: We sought to investigate the analgesic benefits of these novel blocks in terms of opioid-sparing and discharge efficiency.Methods: We conducted a retrospective cohort study with propensity score matching of 224 patients who underwent ambulatory elective unilateral hip arthroscopy. One group received a combined PENG and LFCN block (PENG/LFCN, n = 86), while a second group received only a PENG block (n = 26). A control group (n = 112) received no blocks. The primary outcome was postanesthesia care unit (PACU) mean opioid consumption. Secondary outcomes were maximum numeric rating scale (NRS) pain score, intravenous rescue analgesia, and PACU readiness-for-discharge times.Results: The PENG/LFCN-block group required significantly less opioids than the control group in the PACU (25.98 +/- 13.04 vs 14.58 +/- 5.77, respectively) and were discharged earlier 2.72 +/- 1.16 vs 4.42 +/- 1.63 hours, respectively). The combined PENG/LFCN group also used less intravenous rescue opioids than the control group (0.47 +/- 1.18 vs 1.44 +/- 2.1 mg, respectively) and showed a significant difference in the highest NRS pain scores than the control group (6.01 +/- 2.38 vs 6.77 +/- 2.1 respectively). The PENG block alone group did not show a significant difference in opioid reduction (21.95 +/- 15.83 vs 27.72 +/- 15.01, respectively).Conclusions: This retrospective study found that in patients who underwent ambulatory elective unilateral hip arthroscopy, a combined PENG and LFCN block was associated with expedited PACU discharge and a clinically significant reduction in postoperative opioid use. Further study is warranted.
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关键词:
arthroscopy hip nerve block peripheral nerves postoperative pain ultrasonography FASCIA ILIACA BLOCK MINIMUM EFFECTIVE VOLUME PAIN MANAGEMENT ANALGESIA SURGERY PENG
DOI:
10.1177/15563316231201335
年份:
2024
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