超声引导下髋关节囊周神经阻滞在髋关节镜手术中的应用

魏宏; 杨凯; 吴茜; 姚尚龙

doi:10.14188/j.1671-8852.2023.0465

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超声引导下髋关节囊周神经阻滞在髋关节镜手术中的应用

临床医学研究 | 更新时间：2026-11-05

- 超声引导下髋关节囊周神经阻滞在髋关节镜手术中的应用
- Ultrasound⁃guided pericapsular nerve group block for pain control and motor function in patients undergoing hip arthroscopy
- 武汉大学学报（医学版） 2025年46卷第6期页码：766-770
- 作者机构：
  
  1.华中科技大学协和深圳医院麻醉科广东深圳 518000
  2.华中科技大学同济医学院附属协和医院麻醉科湖北武汉 430022
- 作者简介：
  
  魏宏，女，1980—，医学博士，副主任医师，主要从事围术期疼痛治疗的研究，E⁃mail:weihong269@email.szu.edu.cn
  杨凯，男，1985—，医学博士，主治医师，主要从事围术期疼痛治疗的研究，E⁃mail:364843538@qq.com
  吴茜，女，1993—，医学博士，主治医师，主要从事区域阻滞麻醉的研究，E⁃mail:wuxi@hust.edu.cn
- 基金信息：
  
  深圳市科学创新委员会基础研究面上项目(JCYJ20210324112208023)
- DOI：10.14188/j.1671-8852.2023.0465
  中图分类号： R614.4
- 收稿：2023-08-27，
  
  纸质出版：2025-06-25
- 稿件说明：
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魏宏,杨凯,吴茜等.超声引导下髋关节囊周神经阻滞在髋关节镜手术中的应用[J].武汉大学学报（医学版）,2025,46(06):766-770.

WEI Hong,YANG Kai,WU Xi,et al.Ultrasound⁃guided pericapsular nerve group block for pain control and motor function in patients undergoing hip arthroscopy[J].Medical Journal of Wuhan University,2025,46(06):766-770.
魏宏,杨凯,吴茜等.超声引导下髋关节囊周神经阻滞在髋关节镜手术中的应用[J].武汉大学学报（医学版）,2025,46(06):766-770. DOI： 10.14188/j.1671-8852.2023.0465.

WEI Hong,YANG Kai,WU Xi,et al.Ultrasound⁃guided pericapsular nerve group block for pain control and motor function in patients undergoing hip arthroscopy[J].Medical Journal of Wuhan University,2025,46(06):766-770. DOI： 10.14188/j.1671-8852.2023.0465.

摘要

目的

探讨超声引导下髋关节囊周神经阻滞用于髋关节镜术后镇痛的效果。

方法

选择2021年1—12月择期行髋关节镜手术的患者60例，随机分为髋关节囊周神经阻滞组（PENG阻滞组，简称PENG组）和对照组，每组30例。两组患者均接受全身麻醉，其中PENG组在手术结束后，行患侧髋关节囊周神经阻滞，于髂腰肌腱和耻骨后支之间的筋膜平面推注0.5%罗哌卡因20 mL。记录PENG组患者术后3、6、12和24 h患侧感觉阻滞范围及股四头肌肌力。比较两组患者拔管后30 min及术后3、6、12和24 h的静息及运动视觉模拟评分(VAS）、补救镇痛情况、相关不良反应及术后住院时间等。记录髋关节囊周神经阻滞相关并发症。

结果

研究者术后3 h患者患侧股四头肌肌力下降最快，约为基础水平的40%，之后下降幅度减缓，术后6、12和24 h股四头

肌肌力约为基础水平的72%、80%和96%。拔管后30 min及术后3、6、12和24 h，PENG组静息VAS评分、动态VAS评分、首次补救镇痛时间、补救镇痛比例、补救镇痛药物用量、术后恶心发生率均显著低于对照组（

0.05）。两组患者术后呕吐发生率及术后住院时间差异无统计学意义（

0.05）。PENG组未出现局麻药中毒、穿刺部位感染和血肿等阻滞相关并发症。

结论

超声引导下髋关节囊周阻滞可有效降低髋关节镜患者术后静息疼痛评分、动态疼痛评分及补救镇痛药物用量，保留患者运动功能，优化术后镇痛效果。

Abstract

Objective

To evaluate the analgesic efficacy of ultrasound⁃guided pericapsular nerve group (PENG) block in patients undergoing hip arthroscopy.

Methods

Sixty patients scheduled for elective hip arthroscopy from January to December 2021 were enrolled and randomly divided into two groups: PENG group (

=30) and control group (

=30). Both groups received general anesthesia. For the PENG group

patients received ultrasound⁃guided pericapsular nerve block with 0.5% ropivacaine 20 mL in the musculofascial plane between the psoas tendon and the pubic ramus after the general anesthesia. Visual analogue scores

the first time to rescue analgesia

total requirements for rescue analgesia

the associated side effects

and postoperative length of stay were recorded in the two groups at 3

and 24 h after the surgery. The level of sensory blockade

quadriceps strength on the operative side

and PENG block⁃related complications were recorded in the PENG group.

Results

The quadriceps strength levels on the operated side at 24 h after the surgery returned to 96% of the original baseline level in the PENG group. The visual analogue scores

the first time to rescue analgesia

total requirements for rescue analgesia

and the incidence of nausea at 3

and 24 h after the surgery in the PENG group were significantly less than those in the control group (

0.05). There were no significant differences in the occurrence of vomiting

respiratory depression

and postoperative length of stay between

the two groups. No PENG block⁃related complications were found.

Conclusion

Ultrasound⁃guided pericapsular nerve group block can significantly reduce the visual analogue scores and preserve motor function for patients undergoing hip arthroscopy.

关键词

Keywords

references

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BEHRENDS M , YAP E N , ZHANG A L , 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 .

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