Comparison of Intermittent Bolus and Continuous Infusion Pericapsular Nerve Group Block on Recovery Quality and Analgesic Consumption: A Retrospective Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 82
- 试验地点
- 1
- 主要终点
- Postoperative Pain Scores (VAS)
研究概览
简要总结
This retrospective study evaluates the effects of two different administration methods of the Pericapsular Nerve Group (PENG) Block on postoperative pain control, opioid consumption, and recovery in patients undergoing hip surgery.
All patients in the study received:
- PENG block via a catheter
- Patient-Controlled Analgesia (PCA) with tramadol
- Multimodal analgesia, including IV paracetamol and nonsteroidal anti inflammatory drugs (NSAIDs) as rescue analgesia
The study compares two groups:
- Intermittent Bolus Group: A researcher administered 20 mL of 0.25% bupivacaine every 4 hours.
- Continuous Infusion Group: A pump delivered 5 mL/hour of 0.25% bupivacaine continuously.
Both groups received the same total volume of local anesthetic over 24 hours. All PENG blocks were performed under ultrasound guidance at the end of surgery. This study aims to determine whether intermittent bolus or continuous infusion PENG block administration leads to better pain control, lower opioid consumption, and improved recovery outcomes.
详细描述
Postoperative pain management after hip surgery remains a critical factor in recovery quality, opioid consumption, and overall patient outcomes. Among regional anesthesia techniques, the PENG Block is increasingly utilized for pain control due to its ability to provide effective analgesia while minimizing systemic opioid use. However, the optimal administration method of PENG block remains unclear.
This retrospective cohort study evaluates the effectiveness of two different PENG block administration techniques in patients undergoing hip surgery:
- Intermittent Bolus Group: A researcher manually administered 20 mL of 0.25% bupivacaine every 4 hours via a catheter placed under ultrasound guidance at the end of surgery.
- Continuous Infusion Group: A pump delivered 5 mL/hour of 0.25% bupivacaine continuously via a catheter placed under ultrasound guidance at the end of surgery.
Total local anesthetic volume over 24 hours was equal in both groups.
Study Objectives:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Participants must meet all of the following criteria to be included in the study:
- •Patients who underwent hip surgery between November 15, 2023 - November 15,
- •Patients who received Pericapsular Nerve Group (PENG) Block via a catheter for postoperative analgesia.
- •Patients who received Patient-Controlled Analgesia (PCA) with tramadol.
- •Patients aged 18 to 65 years.
- •ASA I - III classification.
- •BMI ≤ 35 kg/m².
排除标准
- •Participants who meet any of the following criteria will be excluded from the study:
- •Patients who received analgesia with techniques other than PENG block.
- •Patients with incomplete or missing medical records.
- •Patients with a psychiatric illness diagnosis that may interfere with pain perception or reporting.
- •Patients with coagulation disorders (e.g., INR >1.5, thrombocytopenia).
- •Patients with hepatic or renal failure (Creatinine clearance <30 mL/min or AST/ALT >3x normal).
- •Patients with chronic opioid use before surgery.
研究组 & 干预措施
Intermittent Bolus Group
Patients in this group received intermittent bolus administration of the Pericapsular Nerve Group (PENG) Block via a catheter placed under ultrasound guidance at the end of surgery. A researcher manually administered 20 mL of 0.25% bupivacaine every 4 hours over a 24-hour period.
- Total bupivacaine volume: 120 mL of 0.25% bupivacaine over 24 hours
- Additional analgesia: All patients received PCA with tramadol, IV paracetamol, and rescue NSAIDs as per protocol.
干预措施: Intermittent Bolus PENG Block (Procedure)
Continuous Infusion Group
Patients in this group received continuous infusion of the Pericapsular Nerve Group (PENG) Block via a catheter placed under ultrasound guidance at the end of surgery. A pump delivered 5 mL/hour of 0.25% bupivacaine continuously over a 24-hour period.
- Total bupivacaine volume: 120 mL of 0.25% bupivacaine over 24 hours
- Additional analgesia: All patients received PCA with tramadol, IV paracetamol, and rescue NSAIDs as per protocol.
干预措施: Continuous Infusion PENG Block (Procedure)
结局指标
主要结局
Postoperative Pain Scores (VAS)
时间窗: From 0 hours (postoperatively) to 24 hours postoperatively, assessed at 0, 2, 6, 12, and 24 hours.
Postoperative pain levels will be assessed using the Visual Analog Scale (VAS, 0-10) where: * 0 = No pain * 10 = Worst possible pain * Higher scores indicate worse pain levels.
次要结局
- Postoperative Nausea and Vomiting (PONV) Incidence(From 0 hours (postoperatively) to 24 hours postoperatively.)
- Incidence of Complications(From 0 hours (postoperatively) to 24 hours postoperatively.)
- Total Postoperative Opioid Consumption(From 0 hours (postoperatively) to 24 hours postoperatively, assessed at 0, 2, 6, 12, and 24 hours.)
- Quality of Recovery (QoR-15 Score)(Assessed at 24 hours postoperatively.)
- Time to First Rescue Analgesia(From the end of surgery until the first administration of rescue analgesia, assessed up to 24 hours postoperatively.)
研究者
Onur Baran
Asst. Prof.
Namik Kemal University