Evaluation of quadriceps strength during regional analgesia after total hip arthroplasty

Introduction. The presented study examined the strength of the quadriceps femoris muscle with different types of regional analgesia after total hip arthroplasty (THA).

Purpose. To evaluate the strength of the quadriceps femoris muscle using ileofascial (IFB) or pericapsular nerve group block (PENG) in the multimodal analgesia after THA.

Materials and methods. The study included 50 patients who were scheduled to undergo primary THA. Patients were randomly divided into two groups: group 1 (n=25) – patients who underwent IFB, group 2 (n=25) – patients who underwent PENG. In the postoperative period, the strength of the quadriceps femoris muscle was assessed using a muscle strength scale at 3–6–8–12–18–24 hours after surgery. The time of the first verticalization was analyzed. The level of pain syndrome at rest and during movement was recorded after 3–6–12–24 hours using a digital rating scale. The need for narcotic analgesics on the first day after surgery was noted.

Results. Patients with PENG had significantly higher quadriceps strength indicators after 3, 6 and 8 hours after surgery, when compared with patients with IFB (p <0,05). After 12, 18 and 24 hours, statistically significant differences in this indicator were not noted between the groups. The time of the first verticalization was shorter in patients of group 2. The level of pain syndrome at rest and during movement was significantly lower in patients of group 2 12 hours after surgery. No differences were noted in other periods. The number of opioid analgesics prescribed on the first day was significantly lower in the PENG group, compared with the IFB group.

Conclusions. The use of IFB and PENG in multimodal analgesia allows for effective control of pain syndrome indices in the postoperative period after ETS. The use of PENG allows for early activation and motor activity of patients due to the motor-saving effect on the quadriceps muscle of the thigh, which is one of the most important moments in preventing the development of complications and a positive outcome of surgical treatment.

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