Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching
This study aimed to evaluate the effect of a peripheral nerve block (PNB) on immediate postoperative analgesia and the early functional outcomes for patients who underwent total hip arthroplasty (THA). From January 2016 to August 2021, 353 patients who underwent THA were divided into two groups: the...
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| Format: | Article |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/18/5456 |
| _version_ | 1797486570894262272 |
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| author | Heon Jung Park Kwan Kyu Park Jun Young Park Bora Lee Yong Seon Choi Hyuck Min Kwon |
| author_facet | Heon Jung Park Kwan Kyu Park Jun Young Park Bora Lee Yong Seon Choi Hyuck Min Kwon |
| author_sort | Heon Jung Park |
| collection | DOAJ |
| description | This study aimed to evaluate the effect of a peripheral nerve block (PNB) on immediate postoperative analgesia and the early functional outcomes for patients who underwent total hip arthroplasty (THA). From January 2016 to August 2021, 353 patients who underwent THA were divided into two groups: the patient-controlled analgesia (PCA) group (<i>n</i> = 217) who received only intravenous (IV) analgesia, and others who received IV PCA and PNB (PCA + PNB group) (<i>n</i> = 136). After propensity score matching for age and sex, 136 patients from each group were included in the study. Primary outcomes were the visual analogue scale (VAS) at rest, activity status at postoperative 6, 24, 48 h. Secondary outcomes were functional scores by the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, Harris Hip Score (HHS) and rescue medications used. The postoperative VAS at 6, 24, 48 h at rest and 6 h at activity were significantly lower in the PCA + PNB group (<i>p</i> = 0.000, 0.001, 0.000, 0.004 in order). There was no significant difference for postoperative 3-month HHS (<i>p</i> = 0.218), except for 3-month WOMAC index (<i>p</i> = 0.001). There were no significant differences for VAS between the PNB methods except femoral nerve block (FNB) and fascia iliaca compartment block (FICB) at postoperative activity 48 h (<i>p</i> = 0.028). There was no significant difference in the total count and amount of rescue medication (<i>p</i> = 0.091, 0.069) and difference in the quadriceps weakness was not noted. Therefore, PNB is beneficial for patients who undergo THA as it provides sufficient postoperative analgesia, especially during immediate postoperative resting pain without quadriceps weakness. |
| first_indexed | 2024-03-09T23:36:03Z |
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| language | English |
| last_indexed | 2024-03-09T23:36:03Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-6a7cdf992a9b4a8d9d04b64f569c08dc2023-11-23T17:01:04ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011118545610.3390/jcm11185456Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score MatchingHeon Jung Park0Kwan Kyu Park1Jun Young Park2Bora Lee3Yong Seon Choi4Hyuck Min Kwon5Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Orthopedic Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Gyeonggi-do, KoreaDepartment of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaThis study aimed to evaluate the effect of a peripheral nerve block (PNB) on immediate postoperative analgesia and the early functional outcomes for patients who underwent total hip arthroplasty (THA). From January 2016 to August 2021, 353 patients who underwent THA were divided into two groups: the patient-controlled analgesia (PCA) group (<i>n</i> = 217) who received only intravenous (IV) analgesia, and others who received IV PCA and PNB (PCA + PNB group) (<i>n</i> = 136). After propensity score matching for age and sex, 136 patients from each group were included in the study. Primary outcomes were the visual analogue scale (VAS) at rest, activity status at postoperative 6, 24, 48 h. Secondary outcomes were functional scores by the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, Harris Hip Score (HHS) and rescue medications used. The postoperative VAS at 6, 24, 48 h at rest and 6 h at activity were significantly lower in the PCA + PNB group (<i>p</i> = 0.000, 0.001, 0.000, 0.004 in order). There was no significant difference for postoperative 3-month HHS (<i>p</i> = 0.218), except for 3-month WOMAC index (<i>p</i> = 0.001). There were no significant differences for VAS between the PNB methods except femoral nerve block (FNB) and fascia iliaca compartment block (FICB) at postoperative activity 48 h (<i>p</i> = 0.028). There was no significant difference in the total count and amount of rescue medication (<i>p</i> = 0.091, 0.069) and difference in the quadriceps weakness was not noted. Therefore, PNB is beneficial for patients who undergo THA as it provides sufficient postoperative analgesia, especially during immediate postoperative resting pain without quadriceps weakness.https://www.mdpi.com/2077-0383/11/18/5456analgesiapain managementperipheral nerve blockpostoperative paintotal hip arthroplastyvisual analogue scale |
| spellingShingle | Heon Jung Park Kwan Kyu Park Jun Young Park Bora Lee Yong Seon Choi Hyuck Min Kwon Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching Journal of Clinical Medicine analgesia pain management peripheral nerve block postoperative pain total hip arthroplasty visual analogue scale |
| title | Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching |
| title_full | Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching |
| title_fullStr | Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching |
| title_full_unstemmed | Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching |
| title_short | Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching |
| title_sort | peripheral nerve block for pain management after total hip arthroplasty a retrospective study with propensity score matching |
| topic | analgesia pain management peripheral nerve block postoperative pain total hip arthroplasty visual analogue scale |
| url | https://www.mdpi.com/2077-0383/11/18/5456 |
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