Summary

pain management in fai arthroscopy

Abstract

Background

AND OBJECTIVES: Evaluate pain and the use of analgesics (morphine equivalents) in the first 24 hours post-surgery with the use of pericapsular (PENG) block in patients treated with hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Materials And Methods

A prospective, randomized study was conducted, where patients with femoroacetabular impingement syndrome who underwent hip arthroscopy by the same surgeon were evaluated in the 24 hours following surgery. Thirty-five patients who received the PENG block were compared with 35 patients who did not. The duration of the block, visual analog scale (VAS) for pain, and morphine equivalents were assessed in the first 24 hours postoperatively.

Results

Thirty-five patients who received the pericapsular block and thirty-five patients who did not receive the block prior to surgery were identified. No differences were observed in terms of sex, age, surgery time, or type of surgery performed. All patients were treated with 8 mg of intravenous dexamethasone during premedication, along with 75 mg of intravenous diclofenac at the end of the surgery, in addition to infiltration with 6 to 8 ml of 0.75% ropivacaine in each portal. The average duration of the pericapsular block was 17.3 ± 4.56 hours in those who received the block. The VAS score was 3.11 ± 0.99 in the PENG group versus 4.86 ± 1.21 in the group without PENG measured in the first 24 hours. Regarding morphine equivalents used postoperatively, the group that received the block consumed 5.57 ± 4.16 mg compared to 12.43 ± 4.09 mg in the group that did not receive it. All patients were discharged within the first 24 hours after surgery without any associated complications.

Conclusions

The use of the PENG block for postoperative pain management is a promising technique with limited experience. Based on this study, we observed a clear advantage in favor of the PENG block in terms of the VAS score, as well as the use of oral analgesia by patients in the first hours following surgery.