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Войти в исследования Journal of clinical anesthesia · 2026
Minimum effective volume of the pericapsular nerve group (PENG) block in association with a standardized obturator nerve block for analgesia in hip osteoarthritis: An up-and-down study.
СтатьяНазвание и аннотация: Перевод в очереди
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de Andrade Filho Pedro Hilton, da Silva Souza Barbosa Rayane, Tafner Guilherme Pompei, Silva Guilherme Anitele, de Paula Ferreira Maria Fernanda, de Campos Gurgel Henrique Melo, Peng Philip W H, Ashmawi Hazem Adel
Аннотация
BACKGROUND: The pericapsular nerve group (PENG) block has emerged as an effective regional anesthesia technique for managing hip pain, offering substantial analgesia while preserving motor function. However, the minimum effective volume (MEV) required to achieve consistent analgesia in patients with hip osteoarthritis (HOA) has not yet been established. This study aimed to determine the MEV₅₀ of the PENG block necessary to produce clinically meaningful pain relief and to assess the relationship between injectate distribution and analgesic efficacy.
METHODS: This prospective, single-center, up-and-down sequential study included 26 patients with chronic HOA pain. Under ultrasound and fluoroscopic guidance, variable volumes of a local anesthetic mixture were injected for PENG block determined by Dixon's up and down method. The primary outcome was analgesic success, defined as a ≥ 50% reduction in pain during hip flexion 30 min after injection. Secondary outcomes included pain with movement, quadriceps strength, functional performance (Timed Up and Go test), and fluoroscopic injectate spread.
RESULTS: The MEV₅₀ was estimated at 1.53 mL, when combined with a 1 mL obturator nerve injection. Quadriceps strength and mobility were preserved in all patients. Fluoroscopy showed spread between anterior inferior iliac spine and iliopubic eminence and to inferomedial acetabulum in 100% and 58% of cases but the spread did not correlate with analgesic outcome. No adverse events were observed.
CONCLUSION: Low-volume PENG block provides effective and motor-sparing analgesia for HOA, supporting its potential for neurolytic applications in chronic pain management.
METHODS: This prospective, single-center, up-and-down sequential study included 26 patients with chronic HOA pain. Under ultrasound and fluoroscopic guidance, variable volumes of a local anesthetic mixture were injected for PENG block determined by Dixon's up and down method. The primary outcome was analgesic success, defined as a ≥ 50% reduction in pain during hip flexion 30 min after injection. Secondary outcomes included pain with movement, quadriceps strength, functional performance (Timed Up and Go test), and fluoroscopic injectate spread.
RESULTS: The MEV₅₀ was estimated at 1.53 mL, when combined with a 1 mL obturator nerve injection. Quadriceps strength and mobility were preserved in all patients. Fluoroscopy showed spread between anterior inferior iliac spine and iliopubic eminence and to inferomedial acetabulum in 100% and 58% of cases but the spread did not correlate with analgesic outcome. No adverse events were observed.
CONCLUSION: Low-volume PENG block provides effective and motor-sparing analgesia for HOA, supporting its potential for neurolytic applications in chronic pain management.