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1.河北医科大学研究生学院,河北 石家庄 050000
2.衡水市人民医院麻醉科,河北 衡水 053000
靳红绪,E-mail:jinhongxu998@163.com
收稿:2025-03-02,
纸质出版:2026-03-25
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田晨珂,靳红绪.超声引导下髋关节囊周围神经阻滞的研究进展[J].局解手术学杂志,2026,35(03):274-277.
TIAN Chen-ke,JIN Hong-xu.Research progress of ultrasound-guided pericapsular nerve group block[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(03):274-277.
田晨珂,靳红绪.超声引导下髋关节囊周围神经阻滞的研究进展[J].局解手术学杂志,2026,35(03):274-277. DOI: 10.11659/jjssx.03E025003.
TIAN Chen-ke,JIN Hong-xu.Research progress of ultrasound-guided pericapsular nerve group block[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(03):274-277. DOI: 10.11659/jjssx.03E025003.
在髋部骨折围术期管理中,优化区域阻滞镇痛策略面临挑战。腰丛阻滞、髂筋膜间隙阻滞及股神经阻滞等传统方法虽有一定镇痛效果,但在关节囊周边区域的镇痛作用有限。因此,髋关节囊周围神经(PENG)阻滞作为一种新技术应运而生,该技术专注于关节前囊的感觉神经阻滞,旨在为髋部骨折患者提供更为有效的镇痛方案,不仅能避免影响股四头肌肌力,还能最大程度保留下肢运动功能,从而有效减少围术期并发症的发生。鉴于其在促进早期康复方面的积极作用,PENG阻滞技术正逐步在临床实践中得到推广与应用。本文围绕超声引导下PENG阻滞的方法、围术期应用效果、与常规阻滞技术的对比以及该技术临床应用的最新研究进展进行综述,以期为临床实践提供参考依据。
Optimizing the regional block analgesia strategy remains a challenge in the perioperative management of hip fractures.Conventional techniques such as lumbar plexus block,fascia iliaca compartment block and femoral nerve block provide some analgesic effect,yet their analgesic efficacy is limited in the periarticular area of the hip joint.Thus, the pericapsular nerve group (PENG) block of the hip joint has emerged as a novel technique.Focusing on the sensory nerve block of the anterior articular capsule,this technique is designed to provide a more effective analgesia for patients with hip fractures.It not only avoids impairing the strength of the quadriceps femoris muscle but also maximally preserves the motor function of the lower extremities, thereby effectively reducing the incidence of perioperative complications. Owing to its positive role in promoting early rehabilitation, the PENG block technique is gradually gaining popularity in clinical practice. This article reviews the methodology, perioperative application effect, comparison with conventional block techniques, as well as the latest research progress of clinical application of ultrasound-guided PENG block, aiming to provide a reference for clinical practice.
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Kalagara H , Nair H , Kolli S , et al . Ultrasound imaging of the spine for central neuraxial blockade:a technical description and evidence update [J]. Curr Anesthesiol Rep , 2021 , 11 ( 3 ): 326 - 339 . doi: 10.1007/s40140-021-00456-3 http://dx.doi.org/10.1007/s40140-021-00456-3 .
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Balocco AL , Claes E , Lopez A , et al . Selective periarticular blocks for postoperative painafter hip and knee arthroplasty [J]. Curr Opin Anaesthesiol , 2021 , 34 ( 4 ): 544 - 552 . doi: 10.107/ACO.0000000000000943 http://dx.doi.org/10.107/ACO.0000000000000943 .
Girón-Arango L , Peng PWH , Chin KJ , et al . Pericapsular nerve group (PENG) block for hipfracture [J]. Reg Anesth Pain Med , 2018 , 43 ( 8 ): 859 - 863 . doi: 10.1097/AAP.0000000000000847 http://dx.doi.org/10.1097/AAP.0000000000000847 .
Acharya U , Lamsal R . Pericapsular nerve group block:an excellent option for analgesia for positional pain in hip fractures [J]. Case Rep Anesthesiol , 2020 , 2020 : 1830136 . doi: 10.1155/2020/1830136 http://dx.doi.org/10.1155/2020/1830136 .
Mysore K , Sancheti SA , Howells SR , et al . Postoperative analgesia with pericapsular nerve group (PENG) block for primary total hip arthroplasty:a retrospective study [J]. Can J Anaesth , 2020 , 67 ( 11 ): 1673 - 1674 . doi: 10.1007/s12630-020-01751-z http://dx.doi.org/10.1007/s12630-020-01751-z .
谢颖超 , 王美容 , 李志鹏 , 等 . 超声引导下髋关节囊周神经丛阻滞对股骨颈骨折老年患者摆放侧卧位时疼痛的影响 [J]. 临床麻醉学杂志 , 2020 , 36 ( 8 ): 754 - 758 . doi: 10.12089/jca.2020.08.006 http://dx.doi.org/10.12089/jca.2020.08.006 .
Ciftci B , Ahiskalioglu A , Altintas HM , et al . A possible mechanism of motor blockade of high volume pericapsular nerve group (PENG) block:a cadaveric study [J]. J Clin Anesth , 2021 , 74 : 110407 . doi: 10.1016/j.jclinane.2021.110218 http://dx.doi.org/10.1016/j.jclinane.2021.110218 .
单涛 , 韩流 , 葛德高 , 等 . 超声引导下髋关节囊周围神经阻滞联合椎管内麻醉在老年患者全髋关节置换术中的应用 [J]. 临床麻醉学杂志 , 2021 , 37 ( 5 ): 458 - 461 . doi: 10.12089/jca. 2021.05.002 http://dx.doi.org/10.12089/jca.2021.05.002 .
Ahiskalioglu A , Aydin ME , Ozkaya F , et al . A novel indication of pericapsular nerve group (PENG) block:prevention of adductor muscle spasm [J]. J Clin Anesth , 2020 , 60 : 51 - 52 . doi: 10.1016/j.jclinane.2019.08.034 http://dx.doi.org/10.1016/j.jclinane.2019.08.034 .
Öksüz G , Arslan M , Bilal B , et al . A novel indication for pericapsular nerve group (PENG) block:high volume PENG block combination with sciatic block for surgical anesthesia of lower limb [J]. J Clin Anesth , 2021 , 71 : 110218 . doi: 10.1016/j.jclinane.2021.110218 http://dx.doi.org/10.1016/j.jclinane.2021.110218 .
Black ND , Chin KJ . Pericapsular nerve group (PENG) block:comments and practical considerations [J]. J Clin Anesth , 2019 , 56 : 143 - 144 . doi: 10.1016/j.jclinane.2019.02.010 http://dx.doi.org/10.1016/j.jclinane.2019.02.010 .
Mistry T , Sonawane KB , Kuppusamy E . PENG block:points to ponder [J]. Reg Anesth Pain Med , 2019 , 44 ( 3 ): 423 - 424 . doi: 10.1136/rapm-2018-100327 http://dx.doi.org/10.1136/rapm-2018-100327 .
Del Buono R , Padua E , Pascarella G , et al . Continuous PENG block for hip fracture:a case series [J]. Reg Anesth Pain Med , 2020 , 45 ( 10 ): 835 - 838 . doi: 10.2106/JBJS.H.00079 http://dx.doi.org/10.2106/JBJS.H.00079 .
Behrends M , Yap EN , Zhang AL , et al . Preoperative fascia iliaca block does not improve analgesia after arthroscopic hip surgery,but causes quadriceps muscles weakness:a randomized,double-blind trial [J]. Anesthesiology , 2018 , 129 ( 3 ): 536 - 543 . doi: 10.1097/ALN. 0000000000002321 http://dx.doi.org/10.1097/ALN.0000000000002321 .
Choi YS , Park KK , Lee B , et al . Pericapsular nerve group (PENG) block versus supra-inguinal fascia iliaca compartment block for total hip arthroplasty:a randomized clinical trial [J]. J Pers Med , 2022 , 12 ( 3 ): 408 . doi: 10.3390/jpm12030408 http://dx.doi.org/10.3390/jpm12030408 .
Pascarella G , Costa F , Del Buono R , 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 [J]. Anaesthesia , 2021 , 76 ( 11 ): 1492 - 1498 . doi: 10.1111/anae.15536 http://dx.doi.org/10.1111/anae.15536 .
Lin DY , Morrison C , Brown B , et al . Pericapsular nerve group (PENG) block provides improved short-term analgesia compared with the femoral nerve block in hip fracture surgery:a single-center double-blinded randomized comparative trial [J]. Reg Anesth Pain Med , 2021 , 46 ( 5 ): 398 - 403 . doi: 10.1136/rapm-2020-102315 http://dx.doi.org/10.1136/rapm-2020-102315 .
Fujino T , Odo M , Okada H , et al . Continuous pericapsular nerve group block for postoperative pain management in total hip arthroplasty:report of two cases [J]. JA Clin Rep , 2021 , 7 ( 1 ): 22 . doi: 10.1186/s40981-021-00423-1 http://dx.doi.org/10.1186/s40981-021-00423-1 .
杨曙光 , 陶红 , 陈超 , 等 . 超声引导髋关节囊周围神经阻滞在老年髋部骨折病人术前镇痛中的应用 [J]. 骨科 , 2020 , 11 ( 2 ): 140 - 142 . doi: 10.3969/j.issn.1674-8573.2020.02.009 http://dx.doi.org/10.3969/j.issn.1674-8573.2020.02.009 .
Aliste J , Layera S , Bravo D , et al . Randomized comparison between pericapsular nerve group (PENG) block and suprainguinal fascia iliaca block for total hip arthroplasty [J]. Reg Anesth Pain Med , 2021 , 46 ( 10 ): 874 - 878 . doi: 10.1136/rapm-2021-102997 http://dx.doi.org/10.1136/rapm-2021-102997 .
崔明珠 , 曹颖莉 , 苏靖心 . 髋关节囊周围神经阻滞在老年髋关节骨折患者早期镇痛中的应用 [J]. 国际麻醉学与复苏杂志 , 2020 , 41 ( 7 ): 659 - 662 . doi: 10.3760/cma.j.cn321761-20200323-00072 http://dx.doi.org/10.3760/cma.j.cn321761-20200323-00072 .
宋庆迎 , 种朋贵 . 超声下PENG辅助椎管内麻醉在老年患者THA手术中的应用 [J]. 影像科学与光化学 , 2022 , 40 ( 5 ): 1231 - 1235 . doi: 10.7517/issn.1674-0475.220325 http://dx.doi.org/10.7517/issn.1674-0475.220325 .
Morrison C , Brown B , Lin DY , et al . Analgesia and anesthesia using the pericapsular nerve group block in hip surgery and hip fracture:a scoping review [J]. Reg Anesth Pain Med , 2021 , 46 ( 2 ): 169 - 175 . doi: 10.1136/rapm-2020-101826 http://dx.doi.org/10.1136/rapm-2020-101826 .
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