Background and Aims Total hip replacement (THA) is recommended with multimodal analgesia, with peripheral nerve blockade being popular due to its opioid sparing properties1–4. PENG (Pericapsular Nerve Group) block, which has shown analgesic efficacy in THA, preserves sensory supply to the posterior hip capsule5–8. this study compares the analgesic efficacy of PENG block with PENG and PS sciatic nerve block, which blocks the sensory supply to the posterior capsule7,9,10
Methods After informed written consent, 30 ASA (American Society of Anaesthesiologist’s) classification I and II patients scheduled for elective THA were randomised into two groups A and B. After induction of general anaesthesia, Group A received US guided PENG block whereas Group B received combined PENG and PS sciatic nerve block. Post-operatively patients were administered intravenous(IV) fentanyl via. Patient Controlled Analgesia(PCA) pump. Analgesia was compared to PCA fentanyl consumption at 24 and 48 hours, as well as the numerical rating scale (NRS) score at different time intervals
Results Group B had reduced 24 hour (88.3±2mcg vs 69.3±28.5mcg) and 48 hour (158.7±26.4 mcg vs 118.1±24.2 mcg) IV fentanyl intake. In groups A and B, the time for rescue analgesia was 124.51 minutes (min) and 171.2 minutes (min), respectively. Patients in both groups were mobilised 24 hours after surgery, with a median worst NRS score of 4.
Conclusions Combined PENG and PS sciatic nerve block reduces perioperative fentanyl consumption and pain scores in THA patients compared to PENG block.
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