Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded Study
Abstract Introduction Single-injection pericapsular nerve group (PENG) block with ropivacaine provides clear analgesic effects in preoperative pain management for hip fractures. However, it suffers from insufficient duration, failing to meet the needs of most patients. This single-center, randomized...
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Adis, Springer Healthcare
2024-12-01
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| Series: | Pain and Therapy |
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| Online Access: | https://doi.org/10.1007/s40122-024-00683-6 |
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| author | Haobin Peng Jiajun Wen Manli Chen Zhengyuan Xia Ying Jiang Kaiqi Xie Weitao Huang Bangsheng Cui Peixing Li Yiwen Zhang Xianping Wu |
| author_facet | Haobin Peng Jiajun Wen Manli Chen Zhengyuan Xia Ying Jiang Kaiqi Xie Weitao Huang Bangsheng Cui Peixing Li Yiwen Zhang Xianping Wu |
| author_sort | Haobin Peng |
| collection | DOAJ |
| description | Abstract Introduction Single-injection pericapsular nerve group (PENG) block with ropivacaine provides clear analgesic effects in preoperative pain management for hip fractures. However, it suffers from insufficient duration, failing to meet the needs of most patients. This single-center, randomized controlled, observer-blinded trial utilizes a novel combination of liposomal bupivacaine (LB) single-injection PENG block to examine its efficacy, duration, and safety in preoperative analgesia for hip fractures, aiming to develop a new preoperative analgesic protocol. Methods Sixty-six patients with hip fractures received ultrasound-guided single-injection PENG block with LB or ropivacaine after admission. The primary outcome was the static and dynamic pain scores measured at 48 h post-block. Pain scores at 12, 24, 36, 60, and 72 h post-block, rescue analgesia rate, time to first opioid, additional morphine consumption, and adverse events were assessed as the secondary outcomes. Results LB versus ropivacaine group at 48 h post-block, with a median interquartile range (IQR) of 2 (1.0–2.0) versus 3 (2.0–3.0) at static pain score and 2 (1.75–3.0) versus 4 (4.0–5.0) at dynamic pain score. LB group had lower dynamic and static pain scores at other observation points except for the static pain score at 72 h, lower pain intensity [sum of pain intensity difference (SPID)0–24, SPID0–48 and SPID0–72], longer time to first opioid, lower additional morphine consumption, and lower incidence of nausea and vomiting. No significant inter-group differences were detected in other secondary outcomes. Conclusions For preoperative analgesia of hip fractures, LB single-injection PENG block had a similar analgesic intensity and safety as ropivacaine but provided a longer duration of analgesia, reaching 48 h and even extending beyond 60 h, which reduced opioid consumption and extended time to the first opioid. Trial Registration The protocol was registered in www.chictr.org.cn under the identifier ChiCTR2300072939. |
| format | Article |
| id | doaj-art-0f7a1e73ca374033b1419d4c9686efb0 |
| institution | Kabale University |
| issn | 2193-8237 2193-651X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Adis, Springer Healthcare |
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| series | Pain and Therapy |
| spelling | doaj-art-0f7a1e73ca374033b1419d4c9686efb02025-01-26T12:14:03ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2024-12-0114128329610.1007/s40122-024-00683-6Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded StudyHaobin Peng0Jiajun Wen1Manli Chen2Zhengyuan Xia3Ying Jiang4Kaiqi Xie5Weitao Huang6Bangsheng Cui7Peixing Li8Yiwen Zhang9Xianping Wu10Department of Anesthesiology, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineDepartment of Anesthesiology, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineDepartment of Anesthesiology, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineDepartment of Anesthesiology, University of Hong KongDepartment of Anesthesiology, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineDepartment of Anesthesiology, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineDepartment of Orthopedics, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineDepartment of Orthopedics, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineDepartment of Orthopedics, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineDepartment of Anesthesiology, Shunde Hospital of Southern Medical UniversityDepartment of Anesthesiology, Shunde Hospital of Guangzhou University of Traditional Chinese MedicineAbstract Introduction Single-injection pericapsular nerve group (PENG) block with ropivacaine provides clear analgesic effects in preoperative pain management for hip fractures. However, it suffers from insufficient duration, failing to meet the needs of most patients. This single-center, randomized controlled, observer-blinded trial utilizes a novel combination of liposomal bupivacaine (LB) single-injection PENG block to examine its efficacy, duration, and safety in preoperative analgesia for hip fractures, aiming to develop a new preoperative analgesic protocol. Methods Sixty-six patients with hip fractures received ultrasound-guided single-injection PENG block with LB or ropivacaine after admission. The primary outcome was the static and dynamic pain scores measured at 48 h post-block. Pain scores at 12, 24, 36, 60, and 72 h post-block, rescue analgesia rate, time to first opioid, additional morphine consumption, and adverse events were assessed as the secondary outcomes. Results LB versus ropivacaine group at 48 h post-block, with a median interquartile range (IQR) of 2 (1.0–2.0) versus 3 (2.0–3.0) at static pain score and 2 (1.75–3.0) versus 4 (4.0–5.0) at dynamic pain score. LB group had lower dynamic and static pain scores at other observation points except for the static pain score at 72 h, lower pain intensity [sum of pain intensity difference (SPID)0–24, SPID0–48 and SPID0–72], longer time to first opioid, lower additional morphine consumption, and lower incidence of nausea and vomiting. No significant inter-group differences were detected in other secondary outcomes. Conclusions For preoperative analgesia of hip fractures, LB single-injection PENG block had a similar analgesic intensity and safety as ropivacaine but provided a longer duration of analgesia, reaching 48 h and even extending beyond 60 h, which reduced opioid consumption and extended time to the first opioid. Trial Registration The protocol was registered in www.chictr.org.cn under the identifier ChiCTR2300072939.https://doi.org/10.1007/s40122-024-00683-6Hip fractureLiposomal bupivacainePericapsular nerve group blockPreoperative analgesia |
| spellingShingle | Haobin Peng Jiajun Wen Manli Chen Zhengyuan Xia Ying Jiang Kaiqi Xie Weitao Huang Bangsheng Cui Peixing Li Yiwen Zhang Xianping Wu Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded Study Pain and Therapy Hip fracture Liposomal bupivacaine Pericapsular nerve group block Preoperative analgesia |
| title | Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded Study |
| title_full | Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded Study |
| title_fullStr | Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded Study |
| title_full_unstemmed | Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded Study |
| title_short | Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded Study |
| title_sort | preoperative analgesia efficacy of liposomal bupivacaine following pericapsular nerve group peng block in patients with hip fracture a randomized controlled observer blinded study |
| topic | Hip fracture Liposomal bupivacaine Pericapsular nerve group block Preoperative analgesia |
| url | https://doi.org/10.1007/s40122-024-00683-6 |
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