Discussion
hip fracture, fracture, pain, pericapsular nerve block, fractures, nerve block
SEQUELAE OF CEREBRAL INFARCTION, COMPLICATIONS
In this study, PENG block was compared with intravenous flurbiprofen in the management of early analgesia in elderly patients with hip fracture. The results showed that both PENG block and intravenous flurbiprofen resulted in effective pain control, but when compared with intravenous flurbiprofen, PENG block provided better analgesic effects and higher satisfaction with analgesia.PENG block is a new and promising ultrasound-guided regional anesthesia technique that aims to block the branches of the femoral nerve, obturator nerve and accessory obturator nerve innervating the anterior hip capsule [In this prospective, randomized study of 41 elderly patients with hip fractures, one patient had sequelae of cerebral infarction; and although the muscle strength of the left limb was decreased and that of the right limb (fracture side) was normal, we do not think this affected our trial. The PENG block provided analgesia to elderly patients with hip fractures, thus reducing the dynamic and static NRS scores at 15 min, 30 min, 6 h, and 12 h after intervention and the highest NRS scores at 0-12 h compared to intravenous flurbiprofen. Our findings are similar to previously published reports by Pascarella et al [We believe that both groups had similar static and dynamic NRS scores at 24 h, as well as high NRS scores at 12-24 h, because the block resolved; in some studies, researchers have reported that analgesia lasts for 10-15 h after a perineural injection of long-acting local anesthetic [Previous studies believe that the nociceptive innervation of the hip joint mainly comes from the anterior wall of the hip capsule, including the femoral nerve, the obturator nerve, and the joint branch of the accessory obturator nerve [The use of nerve block is an alternative for analgesia in patients with hip fractures when oral analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated or predicted to be ineffective [This study has several limitations. First, this study had a relatively sample size and was not sufficiently powered to observe some rare complications. Second, some studies have shown that a pericapsular nerve block does not affect quadriceps muscle strength and can accelerate patient recovery [In conclusion, compared to intravenous flurbiprofen, ultrasound-guided PENG block is a better early analgesic method for elderly individuals with hip fractures. Additional large-scale randomized clinical trials are needed.