Current Concepts in Postoperative Pain Management Surgeries of Hip Joint: A Narrative Review
Vol 3 | Issue 2 | July-December 2022 | Page 49-55 | Anju Gupta, Mallika Kaushal, Amit Malviya, Shalender Kumar, Sandeep Diwan
DOI: 10.13107/ijra.2022.v03i02.056
Authors: Anju Gupta [1], Mallika Kaushal [1], Amit Malviya [1], Shalender Kumar [1], Sandeep Diwan [2]
[1] Department of Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
[2] Department of Anaesthesia, Sancheti Hospital, Pune, Maharashtra, India.
Address of Correspondence
Dr. Anju Gupta,
Assistant Professor, Department of Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
E-mail: drajugupta09@gmail.com
Abstract
Hip surgery is a common surgical procedure in the elderly and leads to significant pain postoperatively. The hip joint has a complex innervation which is unlikely to be covered with any single modality of pain relief. Multimodal analgesia has been critical in facilitating early recovery and rehabilitation in these patients. Regional analgesia is an important component of multimodal analgesia regimens and is instrumental in achieving optimal patient outcomes. Single shot or continuous central or peripheral nerve blocks provide effective and safe postoperative analgesia, lower opioid consumption, faster rehabilitation, and a high level of patient satisfaction. An ideal regional anaesthesia technique for hip surgery should be motor sparing while providing effective perioperative pain relief. Regional anaesthesia has seen enormous growth in the recent past due to advances in technology and research. These blocks have shown analgesic efficacy, have an opioid-sparing effect, and enable better patient positioning for central neuraxial blocks. Some of the novel interfascial plane blocks like Pericapsular Nerve Group (PENG) block are now being explored for hip analgesia. Within a few years of being described, these novel nerve blocks have seen tremendous favour in the literature and are being extensively used in the current practice of analgesia for hip surgery. In the present review, we aim to discuss the various modalities of analgesia which have been utilised in the past and would discuss few of the newer blocks for hip surgery.
Keywords: Nerve blocks, Ultrasonography, Analgesics, Total hip arthroplasty, Fascia illiaca block,
Multimodal analgesia, Transmuscular, Quadratus lumborum block
References
1. Diwan S, NairA, Dadke M, Sancheti P. Intricacies of ultrasound guided lumbar plexus block in octogenarians:A retrospective case series. J Med Ultrasound 0;0:0
2. Laumonerie P, Dalmas Y, Tibbo ME, Robert S, Durant T, Caste T et al. Sensory innervation of the hip joint and referred pain: A systematic review of the literature. Pain medicine. 2021;22(5):1149-57
3. Anger M, Valovska T, Beloeil H, Lirk P, Joshi GP, Van de Velde M et al. PROSPECT guideline for total hip arthroplasty: a systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia. 2021;76:1082-97
4. Wainwright TW, Gill M, McDonald DA, Middleton RG, Reed M, Sahota O et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Acta orthopaedica. 2020;91(1):3-19
5. Rothwell MP, Pearson D, Hunter JD, Mitchell PA, Graham-Woollard T, Goodwin L et al. Oral oxycodone offers equivalent analgesia to intravenous patient-controlled analgesia after total hip replacement: a randomized, single-centre, non-blinded, non-inferiority study. Br J Anaesth. 2011;106(6):865-72
6. de Beer J de V, Winemaker MJ, Donnelly GA, Miceli PC, Reiz JL, Harsanyi Z et al. Efficacy and safety of controlled-release oxycodone and standard therapies for postoperative pain after knee or hip replacement. Can J Surg. 2005;48(4):277-83
7. Min BW, Kim Y, Cho HM, Park KS, Yoon PW, Nho JH et al. Perioperative pain management in total hip arthroplasty: Korean Hip Society guidelines. Hip Pelvis. 2016; 28(1):15-23.
8. Bujedo BM. A clinical approach to neuraxial morphine for the treatment of postoperative pain. Pain Res Treat. 2012;2012:612145
9. Gandhi K, Viscusi E. Multimodal pain management techniques in hip and knee arthroplasty. The Journal of New York School of Regional Anaesthesia. 2009;13:1-10
10. Brull R, Macfarlane AJR, Chan VWS. Spinal, epidural and caudal anesthesia. In: Gropper M, Erikson L, Fleisher L, Wiener-Kronish J, Cohen N, Leslie K, eds. Miller’s Anesthesia. 9th ed. Elsevier 2019;1:1413-4
11. Choi P, Bhandari M, Scott J, Douketis JD. Epidural analgesia for pain relief following hip or knee replacement. Cochrane database of systematic reviews. 2003;3:CD003071
12. Mannion S. Psoas compartment block. Continuing education in Anaesthesia, Critical Care & Pain. 2007;7(5):162-6
13. Winnie AP, Ramamurthy S, Durrani Z. The inguinal paravascular technic of lumbar plexus anesthesia: the “3-in-1 block”. Anesth Analg. 1973;52(6):989-96
14. Moore CL. Time to abandon the term “3 in 1 block”. Ann Emerg Med. 2015:66(2):215
15. Grant CRK, Checketts MR. Analgesia for primary hip and knee arthroplasty: the role of regional anaesthesia. Continuing education in Anaesthesia, Critical Care & Pain. 2008;8(2):56-61
16. Singelyn FJ, Ferrant T, Malisse MF, Joris D. Effects of patient controlled analgesia with morphine, continuous epidural analgesia, and continuous femoral nerve sheath block on rehabilitation after unilateral total hip arthroplasty. Reg Anesth Pain Med. 2005;30:452-7
17. Nishio S, Fukunishi S, Fukui T, Fujihara Y, Okahisa S, Takeda Y et al. Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study. Orthop Rev (Pavia). 2017;9(2):7063
18. Kuchálik J, Granath B, Ljunggren A, Magnuson A, Lundin A, Gupta A. Postoperative pain relief after total hip arthroplasty: a randomized, double-blind comparison between intrathecal morphine and local infiltration analgesia. Br J Anaesth. 2013;111(5):793-9
19. Ma HH, Chou TFA, Tsai SW, Chen CF, Wu PK, Chen WM. The efficacy of intraoperative periarticular injection in total hip arthroplasty: a systematic review and meta-analysis. BioMed Central Musculoskeletal Disorders. 2019;20:269
20. Dalens B, Vanneuville G, Tanguy A. Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesth Analg. 1989;69:705-13
21. O’Reilly N, Desmet M, Kearns R. Fascia iliaca compartment block. BJA education. 2019;19(6):191-7
22. Zhang X, Ma J. The efficacy of fascia iliaca compartment block for pain control after total hip arthroplasty: a meta-analysis. Journal of orthopaedic surgery and research. 2019;14:33
23. Hong H, Ma Y. The efficacy of fascia iliaca compartment block for pain control after hip fracture: a meta-analysis. Medicine. 2019;98:28(e16157)
24. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block: A novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):621-7
25. Tulgar S, Senturk O. Ultrasound guided erector spinae plane block at L-4 transverse process level provides effective postoperative analgesia for total hip arthroplasty. Journal of clinical anaesthesia. 2018;44:68
26. Azevedo AS, Fernandes HS, Júnior WC, Hamaji A, Ashmawi A. Lumbar erector spinae plane block for total hip arthroplasty analgesia. Case report. BrJP. São Paulo. 2021;4(1):91-3
27. Mujahid OM, Dey S, Nagalikar S, Arora P, Dey CK. Ultrasound-guided lumbar ESP block for post-operative analgesia as an alternative mode of analgesia in hip arthroplasty with multiple systemic issues: a case report. Ain-Shams Journal of Anesthesiology. 2021;13:47
28. Singh S, Ranjan R, Lalin D. A new indication of erector spinae plane block for perioperative analgesia is total replacement surgery – A case report. Indian J Anaesth. 2019;63(4):310-1
29. Kinjo S, Schultz A. Continuous lumbar erector spinae plane block for postoperative pain management in revision hip surgery: a case report. Rev Bras Anestesiol. 2019;69(4):420-2
30. Ahiskalioglu A, Tulgar S, Celik M, Ozer Z, Alici HA, Aydin ME. Lumbar erector spinae plane block as a main anesthetic method for hip surgery in high risk elderly patients: initial experience with a magnetic resonance imaging. Eurasian J Med. 2020;52(1):16-20
31. Xu L, Leng JC, Elsharkawy H, Hunter OO, Harrison TK, Vokach-Brodsky L et al. Replacement of fascia iliaca catheters with continuous erector spinae plane blocks within a clinical pathway facilitates early ambulation after total hip arthroplasty. Pain Medicine. 2020;21(10):2423-9
32. Blanco R. TAP block under ultrasound guidance: the description of a ‘non pops technique’. Reg Anesth Pain Med. 2007;32:130
33. Gupta A, Sondekoppam R, Kalagara H. Quadratus Lumborum Block: A technical review. Curr Anesthesiol Rep. 2019;9:257-62
34. Tiwari P, Bhatia R, Asthana V, Maheshwari R. Role of ultrasound-guided lumbar “Erector spinae plane block” and ultrasound-guided transmuscular “Quadratus lumborum block” for postoperative analgesia after hip surgeries: A randomized, controlled study. Indian Anaesth Forum. 2021;22:60-6
35. Li J, Wei C, Huang J, Li Y, Liu H, Liu J et al. Efficacy of quadratus lumborum block for pain control in patients undergoing hip surgeries: a systematic review and meta-analysis. Front Med. 2022;8:771859
36. Girón-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular Nerve Group (PENG) block for hip fracture. Regional Anesthesia and Pain Medicine. 2018;43:859-63
37. Pascarella G, Costa F, Del Buono R, Pulitano R, Strumia A, Piliego C et al. Impact of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial. Anaesthesia. 2022;76:1492-8
38. Teles AS, Altinpulluk EY, Sahoo RK, Galluccio F, Simón DG, İnce İ et al. Beyond the Pericapsular Nerve Group (PENG) block; a narrative review. Turk J Anaesthesiol Reanim. 2022;50(3):167-72.
How to Cite this Article: Gupta A, Kaushal M, Malviya A, Kumar S, Diwan S | Current Concepts in Postoperative Pain Management Surgeries of Hip Joint: A Narrative Review | International Journal of Regional Anaesthesia | July-December 2022; 3(2): 49-55. |