超声引导下髋关节囊周神经阻滞在小儿髋关节手术中的应用OA北大核心CSTPCD

Objective To compare the analgesic efficacies of ultrasound-guided pericapsular nerve group(PENG block)versus caudal block in children undergoing surgery for developmental dislocation of the hip(DDH).Methods From January 2022 to January 2023,40 children undergoing unilateral correction of DDH under general anesthesia were selected.With a weight range of(10-21)kg,they were aged(1-5)years.The grade of American Society of Anesthesiologists(ASA)was Ⅰ or Ⅱ.They were randomized into two groups of ultrasound-guided caudal block(C,n=20)and ultrasound-guided pericapsular nerve group block(P,n=20).Nerve block was performed with 0.2％ropivacaine 1 mL/kg after an induction of general anesthesia.Face Legs Activity Cry Consolability(FLACC)scores at 1/2/4/8/12/18/24/36/48h post-operation were evaluated.And consumption of sufentanil/sevoflurane,time to initial rescue analgesia,number of rescue doses within 48h,postoperative length of stay,adverse events and parental satisfaction scores were recorded.Results Initial time of rescue analgesia was significantly longer in group P than that in group C[4(4,8)vs.12(8,40.5)h].Total dosage of ibuprofen for rescue analgesia was significantly less in group P than that in group C[(227.0± 142.2)vs.(142.0±114.4)mg].Parental satisfaction score was significantly higher in group P than that in group C[(3.0±0.7)vs.(3.4±0.5)points].No significant inter-group differences existed in intraoperative sufentanil consumption[(9.1±3.4)vs.(8.8±2.6)μg],sevoflurane consumption[(29.0±4.8)vs.(28.8 ±5.6)mL],postoperative length of stay[(7.2±1.2)vs.(6.9±0.9)day],FLACC score or adverse events.Conclusions As compared with caudal block,ultrasound-guided PENG block may prolong the time to initial rescue analgesia within 48h,lower the dosage of analgesics after DDH surgery and lead to higher parental satis-faction in children.It is worthy of further clinical explorations and applications.