文章摘要

髋关节囊周围神经阻滞的临床应用进展

作者: 1黄英, 1董春山, 2朱海娟
1 安徽医科大学第三附属医院麻醉科,合肥市第一人民医院,合肥 230061
2 安徽医科大学附属妇幼保健院麻醉科,合肥 230022
通讯: 董春山 Email: cxh0909@vip.126.com
DOI: 10.3978/j.issn.2095-6959.2022.05.037
基金: 国家自然科学基金(82100315)。

摘要

髋部骨折是老年人急诊手术常见指征。髋部区域手术创伤大,术后疼痛控制不佳会引起一系列并发症如住院时间增加、以及病死率增加等。尤其是老年患者,高龄本身可能会使患者更易受到疼痛的不良影响。神经阻滞技术常用于此类手术的术后镇痛。作为近几年提出的一种新型局部镇痛技术,髋关节囊周围神经阻滞(pericapsular nerve group block,PENG block)已逐渐应用于髋部骨折及其他手术的术后镇痛。不同于以往的神经阻滞,该阻滞效果确切,可有效镇痛且不影响肌力。近年来,随着对髋关节神经支配、周围组织解剖结构和超声下解剖学特点的认识逐渐加深,既往研究显示PENG block有着定位精准、起效快、保留运动功能等优点。因此PENG block技术应用日益广泛,目前正在扩大其适用范围,但随之而来其潜在并发症也应给予高度关注。
关键词: 髋关节囊周围神经阻滞;髋部骨折;镇痛

Clinical application progress in pericapsular nerve group block

Authors: 1HUANG Ying, 1DONG Chunshan, 2ZHU Haijuan
1 Department of Anesthesiology, Third Affiliated Hospital of Anhui Medical University, First People’s Hospital of Hefei, Hefei 230061, China
2 Department of Anesthesiology, Maternal and Child Health Hospital Affiliated to Anhui Medical University, Hefei 230022, China

CorrespondingAuthor: DONG Chunshan Email: cxh0909@vip.126.com

DOI: 10.3978/j.issn.2095-6959.2022.05.037

Foundation: This work was supported by the National Natural Science Foundation of China (82100315).

Abstract

Hip surgery is a common orthopedic emergency among the elderly. The trauma after hip-related procedures is large and poorly treated pain is associated with negative clinical outcomes such as longer postoperative length of stay and higher mortality rates, particularly among older patients. Nerve block techniques have been used to manage postoperative pain. Pericapsular nerve block (PENG block), a new regional block technology proposed in recent years, has been used to relieve pain after hip-related procedures and other procedures. The PENG block has some advantages compared to previous nerve block, including a lack of motor block, precise positioning, fast onset and effectively relieving pain without weakening muscle strength. In recent years, the understanding of the innervation of the hip joint, the anatomical structure of the surrounding tissue and the anatomical characteristics through ultrasound has gradually increased, and the PENG block has been widely used. At present, its applications are expanding and more attention should be paid to the concomitant potential complications.
Keywords: pericapsular nerve group; hip fracture; analgesia

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