Background and Aims Total hip arthroplasty (THA) is associated with severe postoperative pain, traditionally managed using systemic analgesia alone.The Pericapsular Nerve Group Block (PENG Block) provides an effective blockade to the articular branches of the anterior hip joint.It may allow early rehabilitation, with a potential motor-sparing effect. The aim of the study: Evaluate the efficacy of the PENG block for intra and postoperative pain control in THA.
Methods In a controlled-blinded study, patients more than 18 years old scheduled for primary THA under general anesthesia were randomized in two groups: PENG Block group (PG) with 2 mg.kg-1Ropivacaine in 40 ml of saline. Placebo group (SG) who received only saline. Postoperative analgesia with: paracetamol 1g/6H,piroxicam 20 mg and Morphine PCA. The main endpoint was total morphine consumption for 24 hours. Secondary endpoints were: Fentanyl consumption, Pain scores (NRS) at rest and on movement and sitting position.
Sixty patients were included The two groups were comparables. Fentanyl dose was equal in both groups: 345±106 µg in SG vs. 357±65 µg in PG. Morphine consumption was similar in both groups:8.5±5.8mg in SG vs. 9.6 ± 8.2 mg in PG. Time to first request was 1.0±0.6 h for patients in SG vs. 2.0±2.0 h in PG. Pain scores were also not different. Pain free sitting position noted in 50% of patientin two groups.
Conclusions PENG block may improve the quality of recovery and reduce opioid requirements. However, our study did not show a significant impact of PENG block on intra and postoperative pain control in total hip arthroplasty.
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