Comparison of The Volume Dependent Effect of The Pericapsular Nerve Block in Patients with Operated for Femur Fracture
Gamze Dilara Demir, Leyla Kılınç, Mustafa Bilgehan Ayık, Ayşe Surhan Çınar, Aysel Salkaya
Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi Anesteziyoloji ve Reanimasyon Kliniği
Giriş: PENG block is a novel and incresingly used peripheral nerve block for femur fracture. We aimed to compare the effects of PENG block performed with 20 ml to 30 ml volumes of 0.25 % bupivacaine.
Gereç ve Yöntem: After approval of the ethics committee (2021-22-14) and registration of Clinical Trials (NCT05256056) with written obtained sixty ASA I-III patients, who were operated under spinal anesthesia due to femur fracture, were included prospective, randomised study. In Group A (n=30) 20 ml of 0.25% bupivacaine, in Group B (n=30) 30 ml 0.25 % bupivacaine was received for USG guided PENG block. The VAS scores and sensorial block evaluated with a 3-point cold test in the anterior, medial and lateral regions of the inguinal area were before the block,5th, 10th and 20th minutes after the block recorded. Spinal anesthesia was applied in the lateral decubitus position to the patients. 4x1gr paracetamol was given multimodal anlgesia for postoperative period. VAS scores and quadriceps motor power were recorded at the 3rd, 6th, 12th and 24th hours postoperatively. 1 mg/kg tramadol was administered to patients with a VAS score of 4 and above, and the time from block application to tramadol administration was recorded as the duration of analgesia.
Bulgular: There was no significant difference in all-time VAS scores between the groups (p<0,05). The anterior spreads of the groups were similar (p<0,05) but the medial and the lateral spreads were significantly increased in Group B (p=0,01, P<0,01). However, the need for opioid and quadriceps motor weakness did not differ significantly between the groups (p<0,05).
Tartışma ve Sonuç: PENG block applied with in 20 ml volume, provides adequate analgesia for femur fracture. 0.25 % bupivacaine in 30 ml volume can be use for surgery, which need for lateral distrubition of block can be provide analgesia without motor weekness.
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