B64 Comparison of suprainguinal fascia iliaca and peng blocks on postoperative pain and functional recovery after total hip arthroplasty: preliminary results of a non-inferiority trial. (11th August 2022)

• Record Type: Journal Article
• Authors: Carella, M; Beck, F; Piette, N; Lecoq, J-P; Bonhomme, VL
• Is Part Of: Regional anesthesia and pain medicine. Volume 47(2022)Supplement 1
• Page Start: A116
• Page End: A117
• Publication Date: 2022-08-11
• Subjects: Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1136/rapm-2022-ESRA.139
• Languages: English
• ISSNs: 1098-7339

Abstract

Abstract : Background and Aims: Pain after posterolateral-approachedtotal hip arthroplasty (PLTHA) may affect early functional recovery.Supra-inguinal fascia iliaca (SFICB) and pericapsular nerve group blocks (PENG) have been proposed as promising analgesia techniques. 1–3 This trial was conducted to assess non-inferiority of PENG as compared to SFICB for controlling postoperative pain.Secondary outcomes included several assessments functional recovery. Methods: After approval by our local Ethics Committee (2020/381), forty-three patients scheduled for PLTHA with spinal anesthesia were prospectively and randomly allocated to groups.Group S and Group P received SFICB (40 mL ropivacaine 0.375%) or PENG (20 mL ropivacaine 0.75%), respectively.A blinded observer evaluated rest and mobilization pain on a 0–10 numeric rating scale (NRS) at fixed time points: 1h and 6h after surgery, at day-1 and day-2 at 8am, 1pm and 6pm. At day-1 and day-2, evolution on quality-of-recovery-15 score (QoR-15), timed-up-and-go (TUG), 2-minutes (2MWT) and 6-minutes-walking (6MWT) tests were performed.Non-inferiority margin was set as 1 NRS point 6 hours after surgery.Data were analyzed using Mann-Whitney or generalized linear mixed model tests as appropriate. Results: 6-hours after PLTHA, group PNRS was non-inferior to group S NRS ( Figure 1A ).Groups had no significant differences regarding rest and dynamic pain trajectory during the first 48 postoperative hours ( Figure 1B ), as well as regarding motor and functional recovery at day-1 and day-2 as assessed by TUG, 2MWT, 6MWT and QoR-15 ( Figure 2 ). Conclusions: In PLTHA, PENG is non-inferior to SFICB regarding postoperative pain control and no differences are observed regarding postoperative functional recovery.These results should be confirmed once the planned sample size (105) will have been recruited.