广东医学2025，Vol.46Issue(4)：547-552,6.DOI:10.13820/j.cnki.gdyx.20241981
超声引导下髋关节囊周神经与腹股沟韧带上髂筋膜间隙阻滞对全髋关节置换术后镇痛效果的比较
Comparison of postoperative analgesic effects of ultrasound-guided pericapsular nerve group block versus suprainguinal fascia iliaca compartment block in total hip arthroplasty
摘要
Abstract
Objective To compare the postoperative analgesic effects of ultrasound-guided pericapsular nerve group(PENG)block and suprainguinal fascia iliaca compartment(SIFI)block in total hip arthroplasty(THA).The goal is to explore an optimal pain management strategy to facilitate early postoperative mobilization and functional recovery.Methods A total of 80 patients(55 males,25 females),aged 18-60 years,classified as ASA Ⅰ or Ⅱ,undergoing elective THA between March 2021 and December 2022 at two hospitals were enrolled in the study.Patients were randomly assigned to either the PENG block group(P group)or the SIFI block group(S group),with 40 patients in each.In Group P,Prior to general anesthesia induction,ultrasound-guided PENG block was performed on the affected side by in-jecting 20 mL of 0.5％ ropivacaine into the fascial plane between the iliopsoas tendon and the pubic ramus.In Group S,at the same time point,ultrasound-guided SIFI block was administered on the affected side.The probe was placed per-pendicular to the inguinal ligament,and 20 mL of 0.5％ropivacaine was slowly injected between the iliopsoas muscle and the iliac fascia using the hydrodissection technique.All patients received general anesthesia and postoperative analgesia with sufentanil patient-controlled intravenous analgesia(PCIA).Post-extubation at 30 min,and at 3,6,12,and 24 hours postoperatively,the resting and dynamic Visual Analog Scale(VAS)pain scores,need for rescue analgesia,inci-dence of adverse reactions(nausea,vomiting,respiratory depression),and postoperative length of hospital stay were re-corded.Additionally,modified Bromage scores were assessed at 3,6,12,and 24 hours postoperatively.Any block-re-lated complications,such as systemic local anesthetic toxicity,puncture site infection,or hematoma,were monitored.Results The dynamic VAS scores in the P group at 30 min,3 h,and 6 h postoperatively[2(0,5),2.5(0,7),4(0,8)]were significantly lower than those in the S group[3.5(0,7),4(0,8),5.5(0,9)](P＜0.05).However,no significant differences were found in resting VAS scores between the two groups.The modified Bromage scores in the P group at 3 h and 6 h postoperatively[1(1,2),1(1,2)]were significantly lower than those in the S group[2(1,2),2(1.5,2)](P＜0.05),indicating better motor function preservation in the P group.At 12 and 24 hours postoperative-ly,there were no significant differences between the two groups in terms of resting and dynamic VAS scores or modified Bromage scores.Furthermore,no significant differences were observed between the groups in terms of rescue analgesia re-quirements,incidence of nausea and vomiting,or postoperative hospital stay.No cases of systemic local anesthetic toxici-ty,puncture site infection,or hematoma were reported in either group.Conclusion Ultrasound-guided pericapsular nerve group(PENG)block effectively reduces dynamic pain and improves motor function within the first 6 hours after THA.Compared to the suprainguinal fascia iliaca compartment(SIFI)block,PENG block provides superior postoperative analgesia while preserving early mobility,making it an optimal choice for postoperative pain management in THA patients.关键词
超声/髋关节囊周神经阻滞/髂筋膜间隙阻滞/术后镇痛/改良Bromage评分Key words
ultrasound/pericapsular nerve group block/fascia iliaca compartment block/postoperative analgesia/modified Bromage score分类
医药卫生引用本文复制引用
魏宏,许之乔,彭七华,李朝阳,吴茜..超声引导下髋关节囊周神经与腹股沟韧带上髂筋膜间隙阻滞对全髋关节置换术后镇痛效果的比较[J].广东医学,2025,46(4):547-552,6.基金项目
深圳市科技计划项目(JCYJ20210324112208023) （JCYJ20210324112208023）
