[EFFICIENCY OF PERICAPSULAR NERVE GROUP BLOCK AFTER HIP ARTHROPLASTY].

Pericapsular Nerve Group (PENG) is a new regional method for the hip surgery. It can be easily performed under ultrasound control and can provide adequate anesthesia without muscle weakness. The aim of the study was to estimate the clinical effectiveness of the Pericapsular Nerve Group block after hip arthroplasty in terms of analgesia and physical activity of patients. The study included 30 patients (male/female=14/16) with ASA II-III physical status, the average age of the patients was 63.1±12.5 years, who undergone elective primary total hip arthroplasty for coxarthrosis or hip fracture under spinal anesthesia. At the end of the surgery PENG block was performed in the back position of the patient with 30 ml of 0.25% bupivacaine solution. The patients` abilities to overcome a walking distance in 30 meters without time limits were checked. The pain intensity according to Visual Analogue Scale was detected perioperatively. The dose of opioid (nalbuphine) administration, the duration of the PENG-block and the number of patients requiring additional therapy postoperatively were analyzed. The average duration of the PENG block was 8 (7-14) hours and it changed in a wide range with minimum - 4 h to maximum - 25 h. The intensity of postoperative pain was moderate (VAS 5-7 points) in 20% of patients), and mild (VAS 1-4 points) in 77% of patients. In the first 24 hours after the surgery, none of the patients was able to walk more than 30 meters. However, all patients were able to overcome this distance on the first or second postoperative days. The average time needed for such ability was 46 (29 - 55) hours after the blockade. This indicator was influenced by many factors, but it should be noted that nobody showed muscle weakness. 36% of patients did not need opioids on the day of surgery and 16.7% of patients did not need drugs during all postoperative period. 84% of patients did not need any additional pharmacological correction or interventions postoperatively. The PENG block provides adequate postoperative analgesia and allows the early rehabilitation in patients after primary total hip arthroplasty.