Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 16;11(18):5456.
doi: 10.3390/jcm11185456.

Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching

Heon Jung Park  1 , Kwan Kyu Park  1 , Jun Young Park  2 , Bora Lee  3 , Yong Seon Choi  3 , Hyuck Min Kwon  1
Affiliations

Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching

Heon Jung Park et al. J Clin Med. .

Abstract

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 (n = 217) who received only intravenous (IV) analgesia, and others who received IV PCA and PNB (PCA + PNB group) (n = 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 (p = 0.000, 0.001, 0.000, 0.004 in order). There was no significant difference for postoperative 3-month HHS (p = 0.218), except for 3-month WOMAC index (p = 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 (p = 0.028). There was no significant difference in the total count and amount of rescue medication (p = 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.

Keywords: analgesia; pain management; peripheral nerve block; postoperative pain; total hip arthroplasty; visual analogue scale.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for patient selection.
Figure 2
Figure 2
VAS during rest for patients from the PCA and PCA + PNB groups who underwent THA. * Statistically significant difference between two groups (p < 0.05). PCA: patient-controlled analgesia; PNB: peripheral nerve block; THA: total hip arthroplasty; VAS: visual analogue scale.
Figure 3
Figure 3
VAS during activity for patients from the PCA and PCA + PNB groups who underwent THA. * Statistically significant difference between two groups (p < 0.05). PCA: patient-controlled analgesia; PNB: peripheral nerve block; THA: total hip arthroplasty; VAS: visual analogue scale.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Shon W.Y., Park B.Y., Rajsankar R.N., Park P.S., Im J.T., Yun H.H. Total Hip Arthroplasty: Past, Present, and Future. What Has Been Achieved? Hip Pelvis. 2019;31:179–189. doi: 10.5371/hp.2019.31.4.179. - DOI - PMC - PubMed
    1. Ammarullah M.I., Santoso G., Sugiharto S., Supriyono T., Kurdi O., Tauviqirrahman M., Winarni T.I., Jamari J. Tresca Stress Study of CoCrMo-on-CoCrMo Bearings Based on Body Mass Index Using 2D Computational Model. J. Tribol. 2022;33:31–38.
    1. Petis S.M., Howard J.L., Lanting B.A., Marsh J.D., Vasarhelyi E.M. In-Hospital Cost Analysis of Total Hip Arthroplasty: Does Surgical Approach Matter? J. Arthroplast. 2016;31:53–58. doi: 10.1016/j.arth.2015.08.034. - DOI - PubMed
    1. Singelyn F.J., Deyaert M., Joris D., Pendeville E., Gouverneur J.M. Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous three-in-one block on postoperative pain and knee rehabilitation after unilateral total knee arthroplasty. Anesth. Analg. 1998;87:88–92. doi: 10.1213/00000539-199807000-00019. - DOI - PubMed
    1. Choi J.B., Shim Y.H., Lee Y.W., Lee J.S., Choi J.R., Chang C.H. Incidence and risk factors of postoperative nausea and vomiting in patients with fentanyl-based intravenous patient-controlled analgesia and single antiemetic prophylaxis. Yonsei Med. J. 2014;55:1430–1435. doi: 10.3349/ymj.2014.55.5.1430. - DOI - PMC - PubMed

LinkOut - more resources