髋关节囊周围神经阻滞联合切口浸润对全髋关节置换术后镇痛的影响

目的 探究髋关节囊周围神经（pericapsular nerve group，PENG）阻滞联合切口浸润（wound infiltration，WI）对全髋关节置换术（total hip arthroplasty，THA）术后镇痛的影响。方法 选取2021年12月至2022年10月于安徽医科大学第三附属医院行THA的患者78例，根据随机数字表法将其分为PENG阻滞组和PENG阻滞+WI组，每组各39例。比较两组患者的术后静息与运动时数字评分量表（numerical rating scale，NRS）评分、术后运动阻滞发生率、术后首次下地行走时间、抢救性镇痛发生率和不良反应。结果 术后6h、12h，PENG阻滞+WI组患者的静息NRS评分均显著低于PENG阻滞组（P<0.05），术后6h、12h、24h，PENG阻滞+WI组患者的运动NRS评分均显著低于PENG阻滞组（P<0.05）。PENG阻滞+WI组患者的首次下地行走时间显著短于PENG阻滞组（22.48±4.00）h vs.（24.73±1.94）h，t=3.150，P=0.003]。两组患者的抢救性镇痛发生率、不同时点运动阻滞发生率、恶心呕吐、术后躁动发生率比较差异均无统计学意义（P>0.05）。结论 PENG阻滞+WI可减轻THA患者的术后疼痛，有利于早期活动，符合外科所倡导的快速康复理念。

Effect of pericapsular nerve group block with wound infiltration on postoperative analgesia after total hip arthroplasty

Objective To investigate the effect of pericapsular nerve group (PENG) block with wound infiltration (WI) on postoperative analgesia after total hip arthroplasty (THA). Methods A total of seventy-eight patients who were scheduled to undergo THA in the Third Affiliated Hospital of Anhui Medical University from December 2021 to October 2022 were selected. According to random number table method, they were divided into PENG block group and PENG block +WI group, 39 cases in each group. Numerical rating scale (NRS) score of postoperative rest and exercise, incidence of postoperative movement block, first walking time, incidence of rescue analgesia and adverse reactions were compared between two groups. Results At 6h and 12h after surgery, NRS scores at rest in PENG block +WI group were significantly lower than those in PENG block group (P<0.05), and at 6h, 12h and 24h after surgery, NRS scores at exercise in PENG block +WI group were significantly lower than those in PENG block group (P<0.05). The first walking time of patients in PENG block +WI group was significantly shorter than that in PENG block group (22.48±4.00) h vs. (24.73±1.94) h, t=3.150, P=0.003]. There were no significant differences in incidence of rescue analgesia, movement block at different time points, nausea and vomiting, and postoperative agitation between two groups (P>0.05). Conclusion PENG block +WI can reduce the postoperative pain of THA patients, and is conducive to early activity, which is in line with the concept of enhanced recovery after surgery.