40
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Bloqueo de Pericapsular Nerve Group en cirugía de cadera. Experiencia analgésica perioperatoria Translated title: Pericapsular Nerve Group blockade in hip surgery. Perioperative analgesic experience

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Resumen: La fractura de cadera es una entidad quirúrgica que se presenta principalmente en adultos mayores cuyas comorbilidades plantean un reto anestésico. Objetivo: Reportar la experiencia analgésica perioperatoria en pacientes operados de cirugía de cadera en el hospital Angeles Mocel. Material y métodos: Presentamos un estudio observacional, descriptivo y prospectivo de 14 casos intervenidos en los que se realizó bloqueo del grupo de nervios pericapsulares (Pericapsular Nerve Group, PENG por sus siglas en inglés) ecoguiado con 30 mL de ropivacaína 0.5% y en quienes se evaluó dolor referido en reposo y movimiento 20 minutos después de la administración y durante las primeras 10 horas. Resultados: Tras 20 minutos de la administración, el dolor en reposo disminuyó 25.6% y a la movilización activa 39.58% en escala ENA respecto al basal previo al bloqueo. Los pacientes se mantuvieron con dolor leve durante las primeras 10 horas posteriores. Conclusiones: El empleo del bloqueo de PENG es una alternativa eficaz para el control de dolor perioperatorio en casos con cirugía de cadera, brindando analgesia hasta por 10 horas y permitiendo la movilización temprana e inicio de rehabilitación.

          Translated abstract

          Abstract: Hip fractures are surgical entities that are mostly present in elderly individuals with frequently challenging comorbidities. Objective: Report our perioperative analgesic experience in the Angeles Mocel Hospital in patients undergoing hip surgery. Material and methods: We present an observational, descriptive, and prospective study in 14 patients in which ECO-guided PENG block was administered with 30 mL, 0.5% ropivacaine. Referred pain was assessed at rest and at active movement 20 minutes and during the first ten hours after block administration. Results: 20 minutes after block administration, resting referred pain diminished 25.6% points (NRS scale) and active movement referred pain diminished 39.58% according to basal pre-block referral. Patient pain remained mild during the subsequent 10 hours. Conclusions: The PENG block is an effective alternative for perioperative pain management in patients undergoing hip fracture surgery with adequate pain inhibition and facilitated movement and early rehabilitation in the first postsurgical hours.

          Related collections

          Most cited references16

          • Record: found
          • Abstract: found
          • Article: not found

          Pericapsular Nerve Group (PENG) Block for Hip Fracture

          Fascia iliaca block or femoral nerve block is used frequently in hip fracture patients because of their opioid-sparing effects and reduction in opioid-related adverse effects. A recent anatomical study on hip innervation led to the identification of relevant landmarks to target the hip articular branches of femoral nerve and accessory obturator nerve. Using this information, we developed a novel ultrasound-guided approach for blockade of these articular branches to the hip, the PENG (PEricapsular Nerve Group) block. In this report, we describe the technique and its application in 5 consecutive patients.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Postoperative pain treatment after total hip arthroplasty: a systematic review.

            Treatment of postoperative pain should rely on results from randomized controlled trials and meta-analyses of high scientific quality. The efficacy of a particular intervention may depend on the type of surgical procedure, which supports the reporting of "procedure-specific" interventions. The aim of this systematic review was to document the procedure-specific evidence for analgesic interventions after total hip arthroplasty (THA). This PRISMA-compliant and PROSPERO-registered review includes randomized placebo-controlled trials (RCTs) of medication-based analgesic interventions after THA. Endpoints were postoperative opioid consumption, pain scores (rest and during mobilization), adverse events, and length of hospital stay. Fifty-eight trials with 19 different interventions were retrieved. High risk of bias, substantial differences in assessment-tools and criteria for pain, irregular reporting of adverse events, considerable differences in supplemental analgesic consumption, and basic analgesic regimens generally characterized trials. Meta-analyses of non-steroidal anti-inflammatory drugs, local infiltration analgesia, intrathecal opioids, and lumbar plexus block provided a 24-hour intravenous morphine-sparing effect of 14.1 (95 % confidence interval: 8.0-20.2) mg, 7.5 (3.7-11.3) mg, 19.8 (14.9-24.7) mg, and 11.9 (6.4-17.3) mg, respectively. Non-steroidal anti-inflammatory drugs and lumbar plexus block were demonstrated to provide reductions in postoperative pain scores. Intrathecal opioids increased pruritus, and lumbar plexus block reduced nausea and pruritus. The GRADE-rated quality of evidence ranged from low to very low throughout the analyses. This review demonstrated, that some analgesic interventions may have the capacity to reduce mean opioid requirements and/or mean pain intensity compared with controls, but the available randomized placebo-controlled trials does not allow a designation of a "best proven intervention" for THA.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Pericapsular Nerve Group Block: An Excellent Option for Analgesia for Positional Pain in Hip Fractures

              Fractures in and around the hip are common presentations in the emergency department. It is commonly seen in the elderly as a result of osteoporotic changes. However, younger age groups are also affected, especially as a result of high velocity trauma. Irrespective of age, hip fractures are extremely painful, and it is difficult to position the patients for anesthesia procedures. Most of these cases are performed under subarachnoid block (SAB) or combined spinal-epidural anesthesia (CSEA), which requires the patient to be in sitting or lateral position. Here, we report a series of ten cases where pericapsular nerve group (PENG) block was administered prior to positioning the patients for SAB or CSEA. This block is a recently described regional anesthesia technique that provides excellent analgesia for hip fractures. It also provides very good analgesia for patient positioning during procedures such as SAB or CSEA.
                Bookmark

                Author and article information

                Journal
                amga
                Acta médica Grupo Ángeles
                Acta méd. Grupo Ángeles
                Grupo Ángeles, Servicios de Salud (México, Distrito Federal, Mexico )
                1870-7203
                December 2021
                : 19
                : 4
                : 480-484
                Affiliations
                [2] orgnameHospital Angeles Mocel México
                [1] orgnameHospital Angeles Mocel Mexico
                Article
                S1870-72032021000400480 S1870-7203(21)01900400480
                10.35366/102531
                2e272451-c35f-4058-9beb-25652885f18e

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 09 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 5
                Product

                SciELO Mexico

                Categories
                Artículos originales

                analgesia for hip surgery,Bloqueo de PENG,cirugía de cadera,analgesia para cirugía de cadera,PENG blockade,hip surgery

                Comments

                Comment on this article