부산대학교 도서관

Ying Huang,1 Yao Lu,2 Jun Wang,1 Qiang Lu,1 Hai-Feng Bao,1 Lang Liu,1 Chun-Shan Dong1 1 Department of Anaesthesiology, Anhui Medical University Third Affiliated Hospital (Hefei First People’s Hospital), Hefei, Anhui, People’s Republic of China; 2 Department of Anaesthesiology, Anhui Medical University First Affiliated Hospital, Hefei, Anhui, People’s Republic of ChinaCorrespondence: Chun-Shan Dong, Department of Anesthesiology, Third Affiliated Hospital of Anhui Medical University (Hefei First People’s Hospital), Hefei Huaihe Road No. 390, 230061, People’s Republic of China, Tel +86 -13023030292, Email cxh0909@vip.126.comPurpose: The pericapsular nerve group (PENG) block provides satisfactory postoperative analgesia without hampering motor function for total hip arthroplasty (THA); however, unexpected motor block has been observed clinically. It is unknown whether this motor block is related to the dose of ropivacaine. We aimed to conduct a prospective randomized trial to test whether reducing the volume or concentration of ropivacaine was better for less motor block after PENG block.Patients and Methods: Ninety-nine patients with fracture or femoral head necrosis scheduled for THA were randomly allocated to receive 20 mL 0.5% ropivacaine (Group A), 20 mL 0.25% ropivacaine (Group B), and 10 mL 0.5% ropivacaine (Group C). The primary outcome was the incidence of postoperative quadriceps motor block at 6 hours. Secondary outcomes were the incidence of postoperative quadriceps motor block at 0, 12, 24 and 48 hours; pain scores on the numeric rating scale (NRS) at all postoperative time points (0, 6, 12, 24, and 48 hours); the time to first walk; the incidence of rescue analgesia; side effects such as dizziness, ache, nausea, and vomiting; and patient satisfaction.Results: Compared with Group A, Group C resulted in a lower incidence of quadriceps motor block at 0 hours, 6 hours and 12 hours postoperatively (P < 0.05), while Group B only resulted in a lower incidence of motor block at 12 hours postoperatively (P < 0.05). No intergroup differences were found in terms of postoperative pain scores, the incidence of rescue analgesia, adverse events or patient satisfaction (P > 0.05).Conclusion: A higher incidence of motor blockade was observed when 20 mL of 0.5% ropivacaine was administered, which was mainly caused by the excessive volume. Therefore, we recommend performing PENG block with 10 mL 0.5% ropivacaine.Keywords: pericapsular nerve group block, analgesia, motor recovery, ropivacaine