Does Pericapsular Anesthetic Block Improve the Postoperative Period in Transtrochanteric Fractures?

Abstract

Objective: To evaluate pain and mobility in patients with transtrochanteric fractures subjected to osteosynthesis with pericapsular nerve group (PENG) block and compare with patients who did not receive the block. Methods: The medical records of 49 patients were analyzed and data were collected regarding: age, gender, anesthetic evaluation, cause of trauma, locomotion, fracture classification, type of anesthesia used, anesthetic technique, pain, opioid administration and mobility with partial load. Results: Out of 49 patients, 17 (34.7 %) received PENG block. After surgery, most patients complained of pain and opioids were administered (67.3 %), with greatest frequency in the group without PENG block (93.3 %). Most patients who received PENG block walked within 6 h after surgery (52.9 %) and all recovered the ability to walk until hospital discharge (48 h), different from the group that did not receive PENG block (p = 0.012). The groups showed a significant difference between them regarding the frequency of reports of moderate to severe pain (p = 0.003). Conclusion: The use of PENG block in patients with transtrochanteric fractures subjected to osteosynthesis can help to reduce postoperative pain, early mobility with partial load and less use of opioids. Level of Evidence III, Retrospective Comparative Study.

Fratura Transtrocantérica em Idosos: intervalo de tempo entre o trauma e a intervenção cirúrgica

“…As causas mais comuns dessas fraturas são em decorrência de traumas de baixa energia, como queda da própria altura associado à osteoporose (TAVARES, et al, 2022). Ademais, observou-se, em um estudo epidemiológico realizado na Grande Florianópolis, que o diagnóstico de fraturas transtrocantéricas é predominante dentre indivíduos acima de 80 anos de idade (48%) e em indivíduos do sexo feminino (72,4%).…”

The pericapsular nerve group (PENG) block for hip surgery. A narrative review

“…Also, Natrajan et al [39] concluded that the PENG block provides better postoperative analgesia and reduces rescue analgesics requirement in 24 hours compared to the fascia iliaca block in patients undergoing hip surgery. In addition, Zheng et al [25] received that the PENG block provided lower VAS scores, more extended time of the first analgesic consumption, and lower total dose of morphine consumption compared with FICB.…”