The Effect of Pericapsular Nerve Group Block with Liposomal Bupivacaine on Postoperative Rebound Pain in Older Hip Fracture Patients: A Randomized Controlled Trial.
OrthoEvidence Journal (OE Journal) - ACE Report
Epub Ahead of Print
Drug Des Devel Ther. 2025 01-Dec;():. 10.2147/DDDT.S562733What this means for my practice?
Liposomal bupivacaine used in a PENG block significantly reduces postoperative rebound pain and improves analgesia compared with standard local anesthetics in elderly hip fracture patients. This suggests it may enhance recovery and reduce opioid requirements in clinical practice. Key limitations are the small sample size and single-centre design, which may affect generalizability.
Study Summary
Ninety patients with hip fractures were randomized to receive a pericapsular nerve group (PENG) block with liposomal bupivacaine (LB), ropivacaine (R), or saline (C). The primary outcome of interest was postoperative pain, including the numeric rating scale (NRS) scores and incidence of rebound pain. Secondary outcomes included hemodynamic parameters, analgesic consumption, quadriceps function, and adverse events. Outcomes were assessed up to 72 hours postoperatively. Overall, the results of the study revealed that liposomal bupivacaine significantly reduced NRS pain scores and the incidence of rebound pain compared with both ropivacaine and saline. These findings suggest that liposomal bupivacaine PENG block provides superior and prolonged analgesia, improving postoperative recovery in elderly hip fracture patients.
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