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Revista Mexicana de Anestesiología

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2021, Number 3

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Rev Mex Anest 2021; 44 (3)

Catheter placement in continuous PENG blockade in hip surgery

Zaragoza-Lemus G, Céspedes-Korrodi M?, Hernández-Rodríguez D, Mancera-Rangel M
Full text How to cite this article 10.35366/99672

DOI

DOI: 10.35366/99672
URL: https://dx.doi.org/10.35366/99672

Language: Spanish
References: 8
Page: 233-236
PDF size: 299.50 Kb.


Key words:

Hip surgery, analgesia continuous, PENG block, peripheral catheter, regional anesthesia.

ABSTRACT

The control of acute pain in hip surgery is a challenge for the anesthesiologist, not only because of the complexity of the pain derived from osteotomies in a larger joint; but because of the multipathology and fragility that accompanies the geriatric patient. The pericapsular nerve block, known as "PENG block" is a purely sensitive ultrasound-guided block that inhibits the surgical nociceptive impulse of three nerves of the hip joint: the femoral nerve, the obturator nerve and the accessory obturator nerve. This block has an average duration of 10 to 12 hours, prolonging this efficiency and the safety margin provided by this technique led us to place an ultrasound-guided catheter in the PENG block for a male patient scheduled for total hip arthroplasty with the objective of controlling pain up to 48 hours after the surgical procedure, optimizing resources and reducing their hospital stay and reducing the risk of delirium and adverse effects derived from the use of opioids commonly associated in elderly patients. Continuous PENG block is part of multimodal management coupled with general anesthesia or other regional anesthesia techniques, with more hours of analgesia compared to a single dose.


REFERENCES

  1. Girón-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular nerve group (PENG) block for hip fracture. Reg Anesth Pain Med. 2018;43:859-863.

  2. Short AJ, Barnett JJG, Gofeld M, Baig E, Lam K, Agur AMR et al. Anatomic study of innervation of the anterior hip capsule: implication for image-guided intervention. Reg Anesth Pain Med. 2018;43:186-192.

  3. Guay J, Parker MJ, Griffiths R, Kopp S. Peripheral nerve blocks for hip fractures. Cochrane Database Syst Rev. 2017;5:CD001159.

  4. Suksompong S, von Bormann S, von Bormann B. Regional catheters for postoperative pain control: review and observational data. Anesth Pain Med. 2020;10:e99745.

  5. Zaragoza-Lemus G, Portela-Ortiz JM, Díaz-Guevara G. Bloqueo del grupo de nervios pericapsulares (PENG) para cirugía de cadera. Rev Mex Anest. 2020;43:69-72.

  6. Avers D, Brown M. Daniels and Worthingham's muscle testing. Techniques of manual examination and performance testing. St Louis: Elsevier; 2018.

  7. Del Buono R, Padua E, Pascarella G, Soare CG, Barbara E. Continuous PENG block for hip fracture: a case series. Reg Anesth Pain Med. 2020;45:835-838. doi: 10.1136/rapm-2020-101446.

  8. Santos O, Pereira R, Cabral T, Lages N, Machado H. Is continuous PENG block the new 3-in-1 J Anesth Clin Res. 2019;10:898.




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Rev Mex Anest. 2021;44