Christopher S, Dutta S, Gopal TVS. Bilateral pericapsular end nerve blocks for steroid-induced avascular necrosis following COVID-19 infection requiring bilateral total hip replacement. World J Anesthesiol 2024; 13(1): 90514 [DOI: 10.5313/wja.v13.i1.90514]
Corresponding Author of This Article
Somita Christopher, MD, Doctor, Department of Anaesthesiology, Care Hospitals, Flat No. 504 B, Amsri Central Court, Near Lancer Lines, Hyderabad 500025, India. somitachristopher@gmail.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Somita Christopher, Sweety Dutta, Thota Venkata Sanjeev Gopal, Department of Anaesthesiology, Care Hospitals, Hyderabad 500025, India
Author contributions: Christopher S and Dutta S designed and performed the research; Christopher S, Dutta S and Gopal TVS analysed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by Institutional Ethics Committee Care Hospital, No. IEC/CARE/22048/2023/PB.
Informed consent statement: All study participants or their legal guardian provided written consent prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict-of-interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at somitachristopher@gmail.com. Participants gave informed consent for data sharing. No additional data are available.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Somita Christopher, MD, Doctor, Department of Anaesthesiology, Care Hospitals, Flat No. 504 B, Amsri Central Court, Near Lancer Lines, Hyderabad 500025, India. somitachristopher@gmail.com
Received: December 9, 2023 Peer-review started: December 9, 2023 First decision: December 23, 2023 Revised: January 5, 2024 Accepted: February 25, 2024 Article in press: February 25, 2024 Published online: March 11, 2024 Processing time: 89 Days and 18.1 Hours
ARTICLE HIGHLIGHTS
Research background
Avascular necrosis of the hip emerged as a significant complication of steroid use during coronavirus disease 2019 (COVID-19) treatment requiring surgical intervention in the form of bilateral total hip replacements (THR). Pericapsular end nerve block (PENG) has been reported to provide good analgesia after THR. The study aimed to study the efficacy of the block and also add to the present limited knowledge.
Research motivation
The main motivation behind the study was to find an efficient and safe technique to provide analgesia to patients who have undergone bilateral THR surgery. Adequate analgesia will aid in early mobilization, prevent bed sores and deep vein thrombosis, which are important aspects of enhanced recovery after surgery.
Research objectives
The main objective was to evaluate the efficacy of PENG block in patients who underwent bilateral THR. We were able to conclude that the pain scores in patients were significantly low in patients who received PENG block. However, larger comparative studies are required to validate the use of this block.
Research methods
Statistical analysis was performed in R software version 4.3.1. A paired t-test was employed to compare the mean Visual Analog Score (VAS).
Research results
A total of 17 patients were eligible for the study. The mean VAS score was 6.4 pre-operatively and 1.7 12 h after the procedure (P < 0.001). Two patients complained of pain after the PENG block and were therefore excluded from the study. All 15 patients were comfortable and could be mobilized 12 h after surgery.
Research conclusions
This study proposes the use of PENG block for effective analgesia after total hip replacement.
Research perspectives
This is a small study done on patients requiring total hip replacement following steroid use for COVID-19 treatment. We recommend further large comparative studies to test the efficacy of this block.
