PMID- 36964012
OWN - NLM
STAT- MEDLINE
DCOM- 20230519
LR  - 20231027
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Linking)
VI  - 130
IP  - 6
DP  - 2023 Jun
TI  - Quality of recovery after pericapsular nerve group (PENG) block for primary total 
      hip arthroplasty under spinal anaesthesia: a randomised controlled 
      observer-blinded trial.
PG  - 773-779
LID - S0007-0912(23)00078-8 [pii]
LID - 10.1016/j.bja.2023.02.017 [doi]
AB  - BACKGROUND: The pericapsular nerve group (PENG) block is a novel regional 
      anaesthesia technique that has been proposed as an effective motor-sparing block 
      for total hip arthroplasty. Recent randomised studies show conflicting results 
      regarding the analgesic efficacy of the PENG block for total hip arthroplasty. 
      METHODS: We conducted a randomised controlled observer-blinded single-centre 
      superiority trial comparing the efficacy of the PENG block with no block for 
      patients undergoing primary total hip arthroplasty under spinal anaesthesia. All 
      subjects received multimodal analgesia consisting of paracetamol and celecoxib. 
      The primary outcome was quality of recovery (QoR) at 24 h as measured by the 
      QoR-15 questionnaire. RESULTS: A total of 112 participants (56 in each group) 
      were included in the analysis. The median (inter-quartile range [IQR]) 24-h 
      QoR-15 scores were higher in subjects who received a PENG block (132 [116-138]) 
      compared with subjects who did not (103 [97-112]) with a median difference of 26 
      (95% confidence interval, 18-31; P<0.001). Similarly, QoR-15 at 48 h was higher 
      in the PENG group, and opioid use at 24 and 48 h postoperatively was 
      significantly lower in the PENG group. However, we did not find significant 
      differences in pain score, distance to ambulation, or anti-emetic use at any time 
      point. We did not observe any PENG block-related complications. CONCLUSION: 
      Adding a PENG block to a multimodal analgesia regimen that includes paracetamol 
      and celecoxib improves the quality of recovery and reduces opioid requirements 
      for patients undergoing primary total hip arthroplasty under spinal anaesthesia. 
      CLINICAL TRIAL REGISTRATION: NCT04591353.
CI  - Copyright (c) 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.
FAU - Kukreja, Promil
AU  - Kukreja P
AD  - Department of Anesthesiology and Perioperative Medicine, University of Alabama at 
      Birmingham, Birmingham, AL, USA.
FAU - Uppal, Vishal
AU  - Uppal V
AD  - Department of Anesthesia, Perioperative Medicine and Pain Management, Dalhousie 
      University, Nova Scotia Health Authority and IWK Health Centre, Halifax, NS, 
      Canada. Electronic address: v.uppal@dal.ca.
FAU - Kofskey, Alexander M
AU  - Kofskey AM
AD  - Department of Anesthesiology and Perioperative Medicine, University of Alabama at 
      Birmingham, Birmingham, AL, USA.
FAU - Feinstein, Joel
AU  - Feinstein J
AD  - Department of Anesthesiology and Perioperative Medicine, University of Alabama at 
      Birmingham, Birmingham, AL, USA.
FAU - Northern, Theresa
AU  - Northern T
AD  - Department of Anesthesiology and Perioperative Medicine, University of Alabama at 
      Birmingham, Birmingham, AL, USA.
FAU - Davis, Camille
AU  - Davis C
AD  - Department of Anesthesiology, University of Colorado School of Medicine, Aurora, 
      CO, USA.
FAU - Morgan, Charity J
AU  - Morgan CJ
AD  - Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, 
      USA.
FAU - Kalagara, Hari
AU  - Kalagara H
AD  - Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 
      Jacksonville, FL, USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT04591353
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20230322
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
RN  - 0 (Anesthetics, Local)
RN  - 0 (Analgesics, Opioid)
RN  - 362O9ITL9D (Acetaminophen)
RN  - JCX84Q7J1L (Celecoxib)
SB  - IM
CIN - Br J Anaesth. 2023 Jun;130(6):650-654. PMID: 37105898
CIN - Br J Anaesth. 2023 Nov;131(5):e156-e157. PMID: 37689539
MH  - Humans
MH  - *Anesthesia, Spinal/methods
MH  - Anesthetics, Local/therapeutic use
MH  - Analgesics, Opioid/therapeutic use
MH  - Acetaminophen/therapeutic use
MH  - Femoral Nerve
MH  - *Arthroplasty, Replacement, Hip/adverse effects
MH  - Celecoxib/therapeutic use
MH  - Pain, Postoperative/prevention & control/etiology
OTO - NOTNLM
OT  - peri-capsular nerve group (PENG) block
OT  - quality of recovery
OT  - regional anaesthesia
OT  - spinal anaesthesia
OT  - total hip arthroplasty
EDAT- 2023/03/25 06:00
MHDA- 2023/05/19 06:42
CRDT- 2023/03/24 23:04
PHST- 2022/11/14 00:00 [received]
PHST- 2023/02/12 00:00 [revised]
PHST- 2023/02/13 00:00 [accepted]
PHST- 2023/05/19 06:42 [medline]
PHST- 2023/03/25 06:00 [pubmed]
PHST- 2023/03/24 23:04 [entrez]
AID - S0007-0912(23)00078-8 [pii]
AID - 10.1016/j.bja.2023.02.017 [doi]
PST - ppublish
SO  - Br J Anaesth. 2023 Jun;130(6):773-779. doi: 10.1016/j.bja.2023.02.017. Epub 2023 
      Mar 22.