Regional analgesia for total hip arthroplasty and Schwartz's paradox

David W Hewson; Chloe E H Scott; Alan J R Macfarlane

doi:10.1016/j.bja.2023.03.023

Regional analgesia for total hip arthroplasty and Schwartz's paradox

Br J Anaesth. 2023 Jun;130(6):650-654. doi: 10.1016/j.bja.2023.03.023. Epub 2023 Apr 26.

Authors

David W Hewson¹, Chloe E H Scott², Alan J R Macfarlane³

Affiliations

¹ Department of Anaesthesia and Critical Care Medicine, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK; Department of Anaesthesia, Queen's Medicine Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK. Electronic address: david.hewson@nottingham.ac.uk.
² Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK; Department of Orthopaedic Surgery, University of Edinburgh, Edinburgh, UK.
³ Department of Anaesthetics, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.

PMID: 37105898
DOI: 10.1016/j.bja.2023.03.023

Abstract

Enhanced recovery after total hip arthroplasty aims to facilitate return to function and early hospital discharge, but the role of novel fascial plane block techniques in such pathways is uncertain. A randomised trial by Kukreja and colleagues describes superior quality of recovery after hip arthroplasty in patients receiving a pericapsular nerve group (PENG) block. We discuss the trial findings in the context of ongoing uncertainty regarding best analgesic practice for this surgical procedure.

Keywords: PENG block; arthroplasty; enhanced recovery after surgery; hip replacement; peripheral nerve block; regional anaesthesia.

Publication types

Editorial
Comment

MeSH terms

Analgesia* / methods
Arthroplasty, Replacement, Hip*
Femoral Nerve
Humans
Nerve Block* / methods
Pain Management / methods
Pain, Postoperative / drug therapy
Pain, Postoperative / prevention & control