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1.
BMC Anesthesiol ; 22(1): 252, 2022 08 06.
Artículo en Inglés | MEDLINE | ID: mdl-35933328

RESUMEN

BACKGROUND: The PEricapsular Nerve Group (PENG) block is a novel regional analgesia technique that provides improved analgesia in patients undergoing hip surgery while preserving motor function. In this study the PENG block was investigated for analgesia in elective total hip arthroplasty (THA). METHODS: In this multi-centre double-blinded randomized-controlled trial, in addition to spinal anesthesia and local infiltration analgesia (LIA), THA patients received either a PENG block or a sham block. The primary outcome was pain score (numeric rating scale 0-10) 3 h postoperatively (Day 0). Secondary outcomes were postoperative quadriceps muscle strength, postoperative Day 1 pain scores, opiate use, complications, length of hospital stay, and patient-reported outcome measures. RESULTS: Sixty patients were randomized and equally allocated between groups. Baseline demographics were similar. Postoperative Day 0, the PENG group experienced less pain compared to the sham group (PENG: 14 (47%) patients no pain, 14 (47%) mild pain, 2 (6%) moderate/severe pain versus sham: 6 (20%) no pain, 14 (47%) mild pain, 10 (33%) moderate/severe pain; p = 0.03). There was no difference in quadriceps muscle strength between groups on Day 0 (PENG: 23 (77%) intact versus sham: 24 (80%) intact; p = 0.24) and there were no differences in other secondary outcomes. CONCLUSIONS: Patients receiving a PENG block for analgesia in elective THA experience less postoperative pain on Day 0 with preservation of quadriceps muscle strength. Despite these short-term benefits, no quality of recovery or longer lasting postoperative effects were detected.


Asunto(s)
Analgesia , Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Bloqueo Nervioso , Analgesia/métodos , Anestésicos Locales , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Rodilla/métodos , Nervio Femoral , Humanos , Bloqueo Nervioso/métodos , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control
2.
A A Pract ; 15(3): e01433, 2021 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-33760760

RESUMEN

Following the placement of lumbar plexus and parasacral sciatic catheters for complex lower extremity surgery, a 19-kg child had dense sensory and motor blockades in the postanesthesia care unit. The surgical team felt obligated to exclude anatomically modifiable compression of the sciatic nerve and planned for surgical reexploration. Using an insulated short, beveled needle, direct electrical nerve stimulation distal to the parasacral sciatic block and proximal to the surgical site elicited tibial nerve motor function and confirmed nerve integrity. Peripheral nerve stimulation can be used to differentiate between the etiologies of motor blockade in time-critical situations.


Asunto(s)
Bloqueo Nervioso , Estimulación Eléctrica Transcutánea del Nervio , Anestésicos Locales , Niño , Humanos , Nervio Ciático
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