Daniela Bravo1, Rousmery Atton2,3, Diego Mora1, Julián Aliste1,3*
1Department of Anesthesiology and Perioperative Medicine, Hospital Clínico Universidad de Chile, University of Chile, Santiago, Chile
2Department of Anesthesiology, Pontificia Universidad Católica de Chile, Santiago, Chile
3Department of Anesthesiology, Clínica Las Condes, Santiago, Chile
Study Objective: This narrative review discusses the anatomy, mechanism of action, techniques, indications and complications of the pericapsular nerve group block in a hip surgery setting.
Interventions: The MEDLINE, EMBASE and Google Scholar databases (inception to the first week of March 2023) were searched. For anatomy, mechanism of action, techniques, and complications, cadaveric research, randomized trials, retrospective studies and case series were considered. Nonetheless, for surgery indications, to highlight the best evidence available, only randomized trials without major discrepancies with their prospective registration, blinded assessment and sample size justification were retained for analysis.
Main Results: The anatomical studies suggest that pericapsular nerve group block may work through a combination of different mechanisms (i.e., blocking lateral capsule nerves, local anesthetic spread to the femoral nerve, spread towards medial capsule nerves). Compared to alternatives, except for the periarticular local anesthetic infiltration, pericapsular nerves group block results in similar or improved postoperative analgesia in total hip arthroplasty. It should be noted that the motor blockade has not been completely circumvented and the scarcity of adequate studies on other surgical procedures prevents from obtaining further conclusions about its indications.
Conclusions: The pericapsular nerve group block has become very popular after its first description as an analgesic motor-sparing technique for hip fractures. However, without an absolute motor-sparing effect, its current indication is better supported in postoperative analgesia for total hip arthroplasty. Therefore, further investigation is required to find the optimal motor-sparing analgesic block for hip surgery.DOI: 10.29245/2768-5365/2023/2.1141 View / Download Pdf
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Hilde M. Buiting1,2,3,4*, Lisan Ravensbergen4,5, Christa van Schaik6, Vincent K.Y. Ho7
1Antoni van Leeuwenhoek, Netherlands Cancer Institute, Amsterdam, the Netherlands
2University Medical Center, Utrecht, the Netherlands
3University of Amsterdam, Amsterdam, the Netherlands
4O2PZ, Platform of Palliative Care, Amsterdam, the Netherlands
5Red Cross Hospital, Department of Anesthesiology, Beverwijk, the Netherlands
6Meander Medisch Centrum, Department of Medical Oncology, Amersfoort, the Netherlands
7Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands