Effect of Pericapsular Nerve Group Block with Wound Infiltration vs Modified Supra-Inguinal Fascia Iliaca Block on Postoperative Analgesia in Adult Patients Undergoing Total Hip Arthroplasty – A Randomized Clinical Trial
Ying Huang,1 Sheng Peng,1 Jun Wang,2 Lang Liu,2 Chun-Shan Dong2 1 Department of Anesthesiology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2 Department of Anesthesiology, Anhui Medical University Third Affiliated Hospital...
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Dove Medical Press
2025-05-01
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| Series: | Journal of Pain Research |
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| author | Huang Y Peng S Wang J Liu L Dong CS |
| author_facet | Huang Y Peng S Wang J Liu L Dong CS |
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| description | Ying Huang,1 Sheng Peng,1 Jun Wang,2 Lang Liu,2 Chun-Shan Dong2 1 Department of Anesthesiology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2 Department of Anesthesiology, Anhui Medical University Third Affiliated Hospital (Hefei First People’s Hospital), Hefei, Anhui, People’s Republic of ChinaCorrespondence: Chun-Shan Dong, Department of Anesthesiology, Anhui Medical University Third Affiliated Hospital (Hefei First People’s Hospital), Hefei Huaihe Road No. 390, 230061, People’s Republic of China, Tel +86-13023030292, Email cxh0909@vip.126.comPurpose: Pericapsular nerve group (PENG) block and supra-inguinal fascia iliaca block (S-FICB) provides incomplete analgesia for total hip arthroplasty (THA) due to anatomical limitations. This study compares two modified approaches—PENG block with wound infiltration (WI) and a modified S-FICB—to identify the optimal analgesic technique for THA.Patients and Methods: Eighty-six subjects were randomly allocated to either the PENG block + WI group or the modified S-FICB group. The primary outcome was the postoperative numeric rating scale (NRS) pain scores (rest/hip adduction) at 6 hours. The secondary outcomes were pain scores at 12, 24, 48 hours postoperatively and postoperative day 5, the incidence of postoperative quadriceps motor block at 6, 12, 24, 48 hours and postoperative day 5, the mean blood pressure (MAP) at five time points, patient-controlled intravenous analgesia (PCIA) usage and adverse effects such as the incidence of rescue analgesia, local anesthetic systemic toxicity (LAST), postoperative hip infection, the incidence of postoperative nausea and vomiting (PONV) within 5 days after surgery.Results: PENG + WI group had lower NRS at rest (6h) (95% CI 0.51– 1.64, p< 0.001). Compared with the PENG block + WI, the modified S-FICB resulted in a higher incidence of quadriceps motor block at 6 hours (82.1% vs 25.6%; OR=13.257, 95% CI 4.46– 39.38; p< 0.001) and 12 hours (71.8% vs 41%; OR=3.659, 95% CI 1.42– 9.42; p=0.001).Conclusion: PENG block + WI provides sufficient postoperative analgesia with no quadriceps motor block compared to modified S-FICB, supporting early ambulation and in line with the enhanced recovery after surgery (ERAS) protocols.Keywords: total hip arthroplasty, nerve block, analgesia and anesthesia, enhanced recovery after surgery |
| format | Article |
| id | doaj-art-4b011031dbd34edabfa2d7dfa78c280b |
| institution | Matheson Library |
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| language | English |
| publishDate | 2025-05-01 |
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| spelling | doaj-art-4b011031dbd34edabfa2d7dfa78c280b2025-06-25T21:33:47ZengDove Medical PressJournal of Pain Research1178-70902025-05-01Volume 18Issue 126792688103269Effect of Pericapsular Nerve Group Block with Wound Infiltration vs Modified Supra-Inguinal Fascia Iliaca Block on Postoperative Analgesia in Adult Patients Undergoing Total Hip Arthroplasty &ndash; A Randomized Clinical TrialHuang Y0Peng S1Wang J2Liu L3Dong CS4AnaesthesiologyAnaesthesiologyAnaesthesiologyAnaesthesiologyAnaesthesiologyYing Huang,1 Sheng Peng,1 Jun Wang,2 Lang Liu,2 Chun-Shan Dong2 1 Department of Anesthesiology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2 Department of Anesthesiology, Anhui Medical University Third Affiliated Hospital (Hefei First People’s Hospital), Hefei, Anhui, People’s Republic of ChinaCorrespondence: Chun-Shan Dong, Department of Anesthesiology, Anhui Medical University Third Affiliated Hospital (Hefei First People’s Hospital), Hefei Huaihe Road No. 390, 230061, People’s Republic of China, Tel +86-13023030292, Email cxh0909@vip.126.comPurpose: Pericapsular nerve group (PENG) block and supra-inguinal fascia iliaca block (S-FICB) provides incomplete analgesia for total hip arthroplasty (THA) due to anatomical limitations. This study compares two modified approaches—PENG block with wound infiltration (WI) and a modified S-FICB—to identify the optimal analgesic technique for THA.Patients and Methods: Eighty-six subjects were randomly allocated to either the PENG block + WI group or the modified S-FICB group. The primary outcome was the postoperative numeric rating scale (NRS) pain scores (rest/hip adduction) at 6 hours. The secondary outcomes were pain scores at 12, 24, 48 hours postoperatively and postoperative day 5, the incidence of postoperative quadriceps motor block at 6, 12, 24, 48 hours and postoperative day 5, the mean blood pressure (MAP) at five time points, patient-controlled intravenous analgesia (PCIA) usage and adverse effects such as the incidence of rescue analgesia, local anesthetic systemic toxicity (LAST), postoperative hip infection, the incidence of postoperative nausea and vomiting (PONV) within 5 days after surgery.Results: PENG + WI group had lower NRS at rest (6h) (95% CI 0.51– 1.64, p< 0.001). Compared with the PENG block + WI, the modified S-FICB resulted in a higher incidence of quadriceps motor block at 6 hours (82.1% vs 25.6%; OR=13.257, 95% CI 4.46– 39.38; p< 0.001) and 12 hours (71.8% vs 41%; OR=3.659, 95% CI 1.42– 9.42; p=0.001).Conclusion: PENG block + WI provides sufficient postoperative analgesia with no quadriceps motor block compared to modified S-FICB, supporting early ambulation and in line with the enhanced recovery after surgery (ERAS) protocols.Keywords: total hip arthroplasty, nerve block, analgesia and anesthesia, enhanced recovery after surgeryhttps://www.dovepress.com/effect-of-pericapsular-nerve-group-block-with-wound-infiltration-vs-mo-peer-reviewed-fulltext-article-JPRTotal hip arthroplastyNerve blockAnalgesia and anesthesiaEnhanced recovery after surgery. |
| spellingShingle | Huang Y Peng S Wang J Liu L Dong CS Effect of Pericapsular Nerve Group Block with Wound Infiltration vs Modified Supra-Inguinal Fascia Iliaca Block on Postoperative Analgesia in Adult Patients Undergoing Total Hip Arthroplasty &ndash; A Randomized Clinical Trial Journal of Pain Research Total hip arthroplasty Nerve block Analgesia and anesthesia Enhanced recovery after surgery. |
| title | Effect of Pericapsular Nerve Group Block with Wound Infiltration vs Modified Supra-Inguinal Fascia Iliaca Block on Postoperative Analgesia in Adult Patients Undergoing Total Hip Arthroplasty &ndash; A Randomized Clinical Trial |
| title_full | Effect of Pericapsular Nerve Group Block with Wound Infiltration vs Modified Supra-Inguinal Fascia Iliaca Block on Postoperative Analgesia in Adult Patients Undergoing Total Hip Arthroplasty &ndash; A Randomized Clinical Trial |
| title_fullStr | Effect of Pericapsular Nerve Group Block with Wound Infiltration vs Modified Supra-Inguinal Fascia Iliaca Block on Postoperative Analgesia in Adult Patients Undergoing Total Hip Arthroplasty &ndash; A Randomized Clinical Trial |
| title_full_unstemmed | Effect of Pericapsular Nerve Group Block with Wound Infiltration vs Modified Supra-Inguinal Fascia Iliaca Block on Postoperative Analgesia in Adult Patients Undergoing Total Hip Arthroplasty &ndash; A Randomized Clinical Trial |
| title_short | Effect of Pericapsular Nerve Group Block with Wound Infiltration vs Modified Supra-Inguinal Fascia Iliaca Block on Postoperative Analgesia in Adult Patients Undergoing Total Hip Arthroplasty &ndash; A Randomized Clinical Trial |
| title_sort | effect of pericapsular nerve group block with wound infiltration vs modified supra inguinal fascia iliaca block on postoperative analgesia in adult patients undergoing total hip arthroplasty amp ndash a randomized clinical trial |
| topic | Total hip arthroplasty Nerve block Analgesia and anesthesia Enhanced recovery after surgery. |
| url | https://www.dovepress.com/effect-of-pericapsular-nerve-group-block-with-wound-infiltration-vs-mo-peer-reviewed-fulltext-article-JPR |
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