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Pericapsular Nerve Group Block with Periarticular Injection for Pain Management after Total Hip Arthroplasty: A
Hun Sik Cho1, Bo Ra Lee2, Hyuck Min Kwon1
1Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Medical Journal
|March 26, 2025
Summary
Adding a pericapsular nerve group (PENG) block to periarticular multimodal drug injection (PMDI) did not improve pain management or outcomes for total hip arthroplasty (THA) patients. PMDI alone is an effective, safe, and fast method for postoperative pain control after THA.
Area of Science:
- Anesthesiology
- Orthopedic Surgery
- Pain Management
Background:
- Total hip arthroplasty (THA) is a common procedure for hip osteoarthritis.
- Effective postoperative pain management is crucial for patient recovery and satisfaction.
- Current multimodal approaches aim to optimize pain relief while minimizing opioid use.
Purpose of the Study:
- To compare the effectiveness of pericapsular nerve group (PENG) block combined with periarticular multimodal drug injection (PMDI) versus PMDI alone for postoperative pain control and surgical outcomes in THA patients.
- To evaluate if PENG block offers superior pain relief and functional recovery compared to PMDI alone after THA.
Main Methods:
- A randomized controlled trial involving 58 patients undergoing THA from April 2022 to February 2023.
- Patients were assigned to either a PENG block with PMDI group (n=29) or a PMDI-only group (n=29).
- Primary outcomes included numeric rating scale (NRS) pain scores at rest and during activity at 6, 24, and 48 hours postoperatively.
Main Results:
- No significant differences were observed in postoperative NRS pain scores between the PENG block with PMDI group and the PMDI-only group.
- Secondary outcomes, including postoperative complications (nausea, vomiting), sleep quality (RCSQ), hospital stay duration, functional scores (WOMAC, HHS), and total morphine consumption, also showed no significant variations between the groups.
Conclusions:
- The addition of a PENG block to PMDI does not provide additional benefits for postoperative pain management or clinical outcomes in patients undergoing THA via a posterolateral approach.
- Periarticular multimodal drug injection (PMDI) alone is an efficient, rapid, and safe strategy for managing postoperative pain following total hip arthroplasty.
- Further research may explore different approaches or patient populations to ascertain the role of PENG blocks in THA pain management.
