Application Of Pericapsular Nerve Group Block In Perioperative Analgesia In Patients Undergoing Total Hip Arthroplasty

Objective:To explore the analgesic effect of pericapsular nerve group block in perioperative multimodal analgesia in patients with hip arthroplasty.Methods:Ninety-six patients undergoing total hip arthroplasty in our hospital were randomly divided into three groups:control group（group C）,quadratus lumborum block group（group Q）and pericapsular nerve group block group（group P）,with 32 cases in each group.Group C underwent simulated block before operation.Group Q and group P were treated with 20 ml of 0.4%ropivacaine for ultrasound-guided quadratus lumborum block and pericapsular nerve group block before general anesthesia.Sufentanil patient-controlled intravenous analgesia pump was used in the three groups.The static and dynamic NRS scores before（T₀）,10 min（T₁）,20 min（T₂）,30 min（T₃）after nerve block were recorded.The ultrasonic localization time,puncture and drug injection time and block operation time were recorded.The static and dynamic NRS scores at 3 h（T₄）,6 h（T₅）,12 h（T₆）and 24 h（T₇）after operation in the three groups were recorded.The time of first postoperative analgesia pump pressing,the number of effective pressing within 24 hours and the dosage of postoperative remedial analgesic drugs in the three groups were recorded.The occurrence of adverse complications,the time of getting out of bed for the first time and the length of hospital stay after operation were also recorded.Results:Compared with group C,the NRS score of group P decreased significantly at T₁,and the NRS scores of group P and group Q decreased significantly at T₂and T₃（P<0.05）.Compared with group Q,the static NRS score at T1 and the dynamic NRS score at T₁and T₂in group P were significantly lower（P<0.05）.Compared with group Q,the ultrasonic localization time,puncture and drug injection time and block operation time in group P were shorter（P<0.05）.Compared with group C,the NRS scores at T₅,T₆and T₇in group Q and group P decreased（P<0.05）.Compared with group Q,there was no significant difference in NRS score at each time point after operation in group P.Compared with group C,the time of first postoperative remedial analgesia in group Q and group P was significantly longer and the proportion of remedial analgesia was significantly reduced（P<0.05）.Compared with group Q,there was no significant difference in the first remedial analgesia time,the proportion of remedial patients,the effective pressing times of analgesic pump and the dosage of analgesic drugs in group P.At 30 min after nerve block,two patients（about 7%）in group Q had lower limb motor block,and no patient in group P had motor block.There was no difference in the incidence of other adverse complications after operation among the three groups.There was no difference in the first time out of bed and hospital stay among the three groups.Conclusion:When 0.4%ropivacaine 20ml was used for preoperative nerve block in patients with total hip arthroplasty,both pericapsular nerve group block and quadratus lumborum block could play an effective analgesic role.Compared with quadratus lumborum block,the effect of pericapsular nerve group block is faster and the operation time is shorter.The two blocking techniques have the same effect on postoperative analgesia.