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Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report

Introduction: The Pericapsular Nerve Group (PENG) block is a novel technique that allows for analgesia of the anterior hip capsule via the articular branches of the accessory obturator nerve and femoral nerve, which have a significant role in the innervation of the hip capsule. A PENG (Pericapsular...

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Autores principales: Domagalska, Małgorzata, Wieczorowska-Tobis, Katarzyna, Reysner, Tomasz, Geisler-Wojciechowska, Alicja, Grochowicka, Monika, Kowalski, Grzegorz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10059249/
https://www.ncbi.nlm.nih.gov/pubmed/36983637
http://dx.doi.org/10.3390/jpm13030454
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author Domagalska, Małgorzata
Wieczorowska-Tobis, Katarzyna
Reysner, Tomasz
Geisler-Wojciechowska, Alicja
Grochowicka, Monika
Kowalski, Grzegorz
author_facet Domagalska, Małgorzata
Wieczorowska-Tobis, Katarzyna
Reysner, Tomasz
Geisler-Wojciechowska, Alicja
Grochowicka, Monika
Kowalski, Grzegorz
author_sort Domagalska, Małgorzata
collection PubMed
description Introduction: The Pericapsular Nerve Group (PENG) block is a novel technique that allows for analgesia of the anterior hip capsule via the articular branches of the accessory obturator nerve and femoral nerve, which have a significant role in the innervation of the hip capsule. A PENG (Pericapsular Nerves Group) blockade is effective in both adult and pediatric patients. However, no studies on patients under five are available in the literature. Herein, we describe our experience with two pediatric patients with hip dysplasia. Purpose: This study aimed to evaluate the analgesic effect of the pericapsular nerves group (PENG) in preschool children undergoing hip surgery. Patients and methods: This study included two patients, aged 4 and 2 years old, who were qualified for hip surgery. Spinal or general anesthesia with the addition of a PENG block was performed. During the procedure, the basic hemodynamic parameters were monitored. The pain was assessed using the FALCC (Face, Legs, Activity, Cry, Consolability scale) score. A dose of 15 mg/kg(−1) of metamizole was administered if the FLACC score was 3. In the case of a score of 4 on the FLACC scale, the application of 0.2 mg/kg(−1) of nalbuphine was ordered. Results: After the surgery, the patients received 15 mg/kg(−1) IV paracetamol every 6 h to prevent rebound pain. The patient’s hemodynamic parameters were stable and within normal range. In the first 24 h period, the FLACC scores from all patients ranged from 0 to 3. One patient required metamizole 12 h after surgery. No evidence of block complications was observed. Conclusions: This case series showed that the PENG block assured opioid-free pain management and provided adequate postoperative analgesia. However, we are convinced that future randomized, controlled trials are needed in this field.
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spelling pubmed-100592492023-03-30 Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report Domagalska, Małgorzata Wieczorowska-Tobis, Katarzyna Reysner, Tomasz Geisler-Wojciechowska, Alicja Grochowicka, Monika Kowalski, Grzegorz J Pers Med Case Report Introduction: The Pericapsular Nerve Group (PENG) block is a novel technique that allows for analgesia of the anterior hip capsule via the articular branches of the accessory obturator nerve and femoral nerve, which have a significant role in the innervation of the hip capsule. A PENG (Pericapsular Nerves Group) blockade is effective in both adult and pediatric patients. However, no studies on patients under five are available in the literature. Herein, we describe our experience with two pediatric patients with hip dysplasia. Purpose: This study aimed to evaluate the analgesic effect of the pericapsular nerves group (PENG) in preschool children undergoing hip surgery. Patients and methods: This study included two patients, aged 4 and 2 years old, who were qualified for hip surgery. Spinal or general anesthesia with the addition of a PENG block was performed. During the procedure, the basic hemodynamic parameters were monitored. The pain was assessed using the FALCC (Face, Legs, Activity, Cry, Consolability scale) score. A dose of 15 mg/kg(−1) of metamizole was administered if the FLACC score was 3. In the case of a score of 4 on the FLACC scale, the application of 0.2 mg/kg(−1) of nalbuphine was ordered. Results: After the surgery, the patients received 15 mg/kg(−1) IV paracetamol every 6 h to prevent rebound pain. The patient’s hemodynamic parameters were stable and within normal range. In the first 24 h period, the FLACC scores from all patients ranged from 0 to 3. One patient required metamizole 12 h after surgery. No evidence of block complications was observed. Conclusions: This case series showed that the PENG block assured opioid-free pain management and provided adequate postoperative analgesia. However, we are convinced that future randomized, controlled trials are needed in this field. MDPI 2023-02-28 /pmc/articles/PMC10059249/ /pubmed/36983637 http://dx.doi.org/10.3390/jpm13030454 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Domagalska, Małgorzata
Wieczorowska-Tobis, Katarzyna
Reysner, Tomasz
Geisler-Wojciechowska, Alicja
Grochowicka, Monika
Kowalski, Grzegorz
Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report
title Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report
title_full Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report
title_fullStr Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report
title_full_unstemmed Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report
title_short Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report
title_sort pericapsular nerves group (peng) block in children under five years of age for analgesia in surgery for hip dysplasia: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10059249/
https://www.ncbi.nlm.nih.gov/pubmed/36983637
http://dx.doi.org/10.3390/jpm13030454
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