Comparison between supra-inguinal fascia iliaca and pericapsular nerve group blocks on postoperative pain and functional recovery after total hip arthroplasty: A noninferiority randomised clinical trial.

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研究概要

106 patients undergoing elective posterolateral total hip arthroplasty (PLTHA) under spinal anesthesia (SA) were included in this non inferiority randomized controlled trial in which patients were randomly allocated to receive a supra-inguinal fascia iliac block (SFIB; n=53) or pericapsular nerve group blocks (PENG; n=53). The primary outcome of interest was pain at rest measured by numeric rating scale (NRS) 6 hours postoperatively. The secondary outcomes of interest included NRS pain at rest and on mobilization for all other timepoints during the first 48 hours [1 hour and 6 hours after surgery; and on postoperative days (POD) 1 and 2 at 8am, 1pm and 6pm), total morphine consumption, timed up-and-go test (TUG), the 2-min walking distance test (2MWT), 6-min walking distance test (6-MWT], the quality-of-recovery 15-items score (QoR-15), incidence of falls and orthostatic intolerance at 48 h after surgery and morphine-related side effects on POD 1 and 2. Other secondary outcomes included the Tampa Scale of Kinesiophobia (TSK), length of hospital stay, Douleur Neuropathique 4 Questions (DN4) scale, and the French-validated International Pain Outcomes (IPO) questionnaire for pain management. The results of the study show that PENG was non inferior to SFIB with respect to post operative pain control at 6 hours. No significant differences were found between groups with respect to pain trajectories during the first 48 hours, functional recovery and performance outcomes (TUG, 2MWT, 6MWT, QoR-15) at all time points, or for TSK, DN4 and IPO. There were also no significant between-group differences observed for cumulative morphine consumption or morphine related side effects, incidence of orthostatic intolerance and length of stay.