PMID- 37355181
OWN - NLM
STAT- MEDLINE
DCOM- 20240202
LR  - 20240226
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 40
IP  - 2
DP  - 2024 Feb
TI  - Pericapsular Nerve Group Block Leads to Small but Consistent Reductions in Pain 
      Between 18 and 24 Hours Postoperatively in Hip Arthroscopy for Femoroacetabular 
      Impingement Surgery: A Prospective, Randomized Controlled Clinical Trial.
PG  - 373-380
LID - S0749-8063(23)00467-X [pii]
LID - 10.1016/j.arthro.2023.06.016 [doi]
AB  - PURPOSE: To investigate whether the use of a pericapsular nerve group (PENG) 
      block would reduce perioperative pain after arthroscopic therapy for 
      femoroacetabular impingement syndrome (FAIS) and to examine opioid requirements 
      and occurrence of postoperative nausea and vomiting (PONV). METHODS: Between May 
      2022 and October 2022, patients (N = 68) undergoing arthroscopic surgery for FAIS 
      were randomly allocated into 2 groups. The first group received an 
      ultrasound-guided PENG preoperatively with 20 mL of 0.375% ropivacaine and 
      standardized postoperative oral medication. The second group received a sham 
      block preoperatively with 20 mL of 0.9% saline and standardized postoperative 
      oral medication. The primary end point was pain scores (visual analog score 
      [VAS], 0-10) during the first 24 hours postoperatively. To quantify clinical 
      significance of outcome achievement for the VAS pain score, the minimal 
      clinically important difference (MCID) was calculated using the half standard 
      deviation method. The incidence of PONV as well as opioid usage (converted to 
      morphine equivalent) within the first 24 hours were secondary outcomes. RESULTS: 
      Randomization and permission were successfully obtained from 68 participants. 
      From the fifteenth postoperative hour, the PENG group reported significantly less 
      postoperative pain than the control group (24th postoperative hour: VAS pain PENG 
      group 1.3 +/- 0.9 [0-3]; 95% confidence interval CI 0.4-1.2 vs the VAS pain 
      control group 2.4 +/- 1.6 [0-5]; 95% CI 1.4-4.7; P = .009). The VAS pain score 
      threshold for achieving the MCID at 24 hours postoperative was defined as a 
      decrease of 1.1. 27 patients (79%) in the PENG group and 22 patients (65%) in the 
      control group were able to achieve MCID (P = .009). Opioid dosage and 
      postoperative nausea did not differ significantly between groups (P = .987 and 
      P = .655, respectively). Concomitant complications such as falls, hematomas, or 
      weakened muscles did not occur in either group. CONCLUSIONS: According to this 
      study, a PENG block minimally reduced pain after arthroscopic treatment for FAIS 
      between the 18th and 24th postoperative hours. The PENG group achieved 
      significantly more often the pain VAS MCID. However, there was no proof that the 
      PENG group consumed fewer opioids than the control group. Overall, PONV was found 
      at a low and comparable rate. LEVEL OF EVIDENCE: Level I, randomized controlled 
      trial.
CI  - Copyright (c) 2023 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Eppel, Benjamin
AU  - Eppel B
AD  - ARCUS Sportklinik, Pforzheim, Germany.
FAU - Schneider, Marco M
AU  - Schneider MM
AD  - MVZ Praxisklinik Orthopadie Aachen, University of Aachen, Aachen, Germany; 
      University Witten/Herdecke, Witten, Germany.
FAU - Gebhardt, Sebastian
AU  - Gebhardt S
AD  - Department of Orthopaedics, University Medicine Greifswald, Greifswald, Germany.
FAU - Balcarek, Peter
AU  - Balcarek P
AD  - ARCUS Sportklinik, Pforzheim, Germany.
FAU - Sobau, Christian
AU  - Sobau C
AD  - ARCUS Sportklinik, Pforzheim, Germany.
FAU - Wawer Matos, Johannes
AU  - Wawer Matos J
AD  - ARCUS Sportklinik, Pforzheim, Germany.
FAU - Zimmerer, Alexander
AU  - Zimmerer A
AD  - ARCUS Sportklinik, Pforzheim, Germany; Department of Orthopaedics, University 
      Medicine Greifswald, Greifswald, Germany; Orthopadische Klinik Paulinenhilfe, 
      Diakonie-Klinikum Stuttgart, Germany. Electronic address: 
      alexander.zimmerer@diak-stuttgart.de.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20230622
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
RN  - 0 (Analgesics, Opioid)
SB  - IM
CIN - Arthroscopy. 2024 Mar;40(3):661-662. PMID: 38206245
CIN - Arthroscopy. 2024 Feb;40(2):381-383. PMID: 38296442
MH  - Humans
MH  - *Femoracetabular Impingement/surgery
MH  - Arthroscopy/methods
MH  - Analgesics, Opioid/therapeutic use
MH  - Prospective Studies
MH  - Femoral Nerve
MH  - Postoperative Nausea and Vomiting/prevention & control
MH  - Pain, Postoperative/drug therapy/prevention & control
EDAT- 2023/06/25 01:08
MHDA- 2024/02/02 06:42
CRDT- 2023/06/24 19:17
PHST- 2022/12/19 00:00 [received]
PHST- 2023/05/29 00:00 [revised]
PHST- 2023/06/01 00:00 [accepted]
PHST- 2024/02/02 06:42 [medline]
PHST- 2023/06/25 01:08 [pubmed]
PHST- 2023/06/24 19:17 [entrez]
AID - S0749-8063(23)00467-X [pii]
AID - 10.1016/j.arthro.2023.06.016 [doi]
PST - ppublish
SO  - Arthroscopy. 2024 Feb;40(2):373-380. doi: 10.1016/j.arthro.2023.06.016. Epub 2023 
      Jun 22.