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Periarticular Injection Versus Peripheral Nerve Blockade in Bilateral Total Hip Arthroplasty

Pain control after total hip arthroplasty is associated with patient satisfaction, early discharge, and improved surgical outcomes. Two commonly utilized opioid-reducing analgesic modalities are periarticular injection (PAI) by surgeons and motor-sparing peripheral nerve block (PNB) by anesthesiolog...

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Detalles Bibliográficos
Autores principales: Sivco, Carolyn, Townsend, Dahlia, Leslie, Michael P, Li, Jinlei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290567/
https://www.ncbi.nlm.nih.gov/pubmed/37366446
http://dx.doi.org/10.7759/cureus.39503
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author Sivco, Carolyn
Townsend, Dahlia
Leslie, Michael P
Li, Jinlei
author_facet Sivco, Carolyn
Townsend, Dahlia
Leslie, Michael P
Li, Jinlei
author_sort Sivco, Carolyn
collection PubMed
description Pain control after total hip arthroplasty is associated with patient satisfaction, early discharge, and improved surgical outcomes. Two commonly utilized opioid-reducing analgesic modalities are periarticular injection (PAI) by surgeons and motor-sparing peripheral nerve block (PNB) by anesthesiologists. We present a case contrasting PAI and PNB in a single patient undergoing bilateral total hip arthroplasty. For the left hip, the patient received preoperative transmuscular quadratus lumborum, femoral nerve, and lateral femoral cutaneous nerve blocks using a combination of low-concentration local anesthetic and glucocorticoids. For the right hip, the patient received an intraoperative PAI with liposomal bupivacaine. The patient's pain scores and recovery were evaluated for three months postoperatively. The patient's pain scores on postoperative day (POD) zero to five were consistently lower in the left hip than in the right hip. For this patient undergoing bilateral hip replacement, preoperative PNBs were superior to PAI for postoperative pain control.
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spelling pubmed-102905672023-06-26 Periarticular Injection Versus Peripheral Nerve Blockade in Bilateral Total Hip Arthroplasty Sivco, Carolyn Townsend, Dahlia Leslie, Michael P Li, Jinlei Cureus Anesthesiology Pain control after total hip arthroplasty is associated with patient satisfaction, early discharge, and improved surgical outcomes. Two commonly utilized opioid-reducing analgesic modalities are periarticular injection (PAI) by surgeons and motor-sparing peripheral nerve block (PNB) by anesthesiologists. We present a case contrasting PAI and PNB in a single patient undergoing bilateral total hip arthroplasty. For the left hip, the patient received preoperative transmuscular quadratus lumborum, femoral nerve, and lateral femoral cutaneous nerve blocks using a combination of low-concentration local anesthetic and glucocorticoids. For the right hip, the patient received an intraoperative PAI with liposomal bupivacaine. The patient's pain scores and recovery were evaluated for three months postoperatively. The patient's pain scores on postoperative day (POD) zero to five were consistently lower in the left hip than in the right hip. For this patient undergoing bilateral hip replacement, preoperative PNBs were superior to PAI for postoperative pain control. Cureus 2023-05-25 /pmc/articles/PMC10290567/ /pubmed/37366446 http://dx.doi.org/10.7759/cureus.39503 Text en Copyright © 2023, Sivco et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Anesthesiology
Sivco, Carolyn
Townsend, Dahlia
Leslie, Michael P
Li, Jinlei
Periarticular Injection Versus Peripheral Nerve Blockade in Bilateral Total Hip Arthroplasty
title Periarticular Injection Versus Peripheral Nerve Blockade in Bilateral Total Hip Arthroplasty
title_full Periarticular Injection Versus Peripheral Nerve Blockade in Bilateral Total Hip Arthroplasty
title_fullStr Periarticular Injection Versus Peripheral Nerve Blockade in Bilateral Total Hip Arthroplasty
title_full_unstemmed Periarticular Injection Versus Peripheral Nerve Blockade in Bilateral Total Hip Arthroplasty
title_short Periarticular Injection Versus Peripheral Nerve Blockade in Bilateral Total Hip Arthroplasty
title_sort periarticular injection versus peripheral nerve blockade in bilateral total hip arthroplasty
topic Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290567/
https://www.ncbi.nlm.nih.gov/pubmed/37366446
http://dx.doi.org/10.7759/cureus.39503
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