Pericapsular nerve group (PENG) block for early pain management of elderly patients with hip fracture : a single-center double-blind randomized controlled trial
© American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ..
BACKGROUND: The pericapsular nerve group block (PENG) is a novel technique that blocks the articular branches of the hip joint. This study aimed to compare its effectiveness to a sham block in elderly patients with hip fractures.
METHOD: A randomized double-blind controlled trial was conducted in elderly patients with intertrochanteric and neck of femur fractures. Patients were randomized to receive either PENG block or a sham block. Postblock, systemic analgesia was titrated using a standardized protocol of acetaminophen, oral morphine or patient-controlled analgesia. The primary outcome was the dynamic pain score (Numerical Rating Scale 0-10) at 30 min postblock. Secondary outcomes included pain scores at multiple other time points and 24-hour opioid consumption.
RESULTS: 60 patients were randomized and 57 completed the trial (PENG n=28, control n=29). Patients in PENG group had significantly lower dynamic pain scores at 30 min compared with control group (median (IQR) 3 (0.5-5) vs 5 (3-10), p<0.01). For the secondary outcomes, dynamic pain scores were lower in PENG group at 1 hour (median (IQR) 2 (1-3.25) vs 5 (3-8), p<0.01) and 3 hours postblock (median (IQR) 2 (0-5) vs 5 (2-8), p<0.05). Patients in PENG group had lower 24-hour opioid consumption (median (IQR) oral morphine equivalent dose 10 (0-15) vs 15 (10-30) mg, p<0.05).
CONCLUSION: PENG block provided effective analgesia for acute traumatic pain following hip fracture. Further studies are required to validate the superiority of PENG blocks over other regional techniques.
TRIAL REGISTRATION NUMBER: NCT04996979.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Regional anesthesia and pain medicine - 48(2023), 11 vom: 13. Nov., Seite 535-539 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lin, Xufeng [VerfasserIn] |
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| Links: |
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| Themen: |
Analgesics, Opioid |
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| Anmerkungen: |
Date Completed 25.09.2023 Date Revised 05.10.2023 published: Print-Electronic ClinicalTrials.gov: NCT04996979 Citation Status MEDLINE |
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| doi: |
10.1136/rapm-2022-104117 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a BACKGROUND: The pericapsular nerve group block (PENG) is a novel technique that blocks the articular branches of the hip joint. This study aimed to compare its effectiveness to a sham block in elderly patients with hip fractures | ||
| 520 | |a METHOD: A randomized double-blind controlled trial was conducted in elderly patients with intertrochanteric and neck of femur fractures. Patients were randomized to receive either PENG block or a sham block. Postblock, systemic analgesia was titrated using a standardized protocol of acetaminophen, oral morphine or patient-controlled analgesia. The primary outcome was the dynamic pain score (Numerical Rating Scale 0-10) at 30 min postblock. Secondary outcomes included pain scores at multiple other time points and 24-hour opioid consumption | ||
| 520 | |a RESULTS: 60 patients were randomized and 57 completed the trial (PENG n=28, control n=29). Patients in PENG group had significantly lower dynamic pain scores at 30 min compared with control group (median (IQR) 3 (0.5-5) vs 5 (3-10), p<0.01). For the secondary outcomes, dynamic pain scores were lower in PENG group at 1 hour (median (IQR) 2 (1-3.25) vs 5 (3-8), p<0.01) and 3 hours postblock (median (IQR) 2 (0-5) vs 5 (2-8), p<0.05). Patients in PENG group had lower 24-hour opioid consumption (median (IQR) oral morphine equivalent dose 10 (0-15) vs 15 (10-30) mg, p<0.05) | ||
| 520 | |a CONCLUSION: PENG block provided effective analgesia for acute traumatic pain following hip fracture. Further studies are required to validate the superiority of PENG blocks over other regional techniques | ||
| 520 | |a TRIAL REGISTRATION NUMBER: NCT04996979 | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Anesthesia, Conduction | |
| 650 | 4 | |a Lower Extremity | |
| 650 | 4 | |a Pain Management | |
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| 700 | 1 | |a Goh, Qing Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Sim, Eileen Yilin |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Steffi Kang Ting |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Zhen Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Diana Xin Hui |e verfasserin |4 aut | |
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