ArticleClinical research in cardiology : official journal of the German Cardiac Society2025
Pericapsular nerve group block reduces fentanyl use in transcatheter aortic valve implantation: a randomized prospective study.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05904912 (Evaluation of the Effect of Ultrasound-guided PENG Block on Postoperative Analgesia Management in Patients Undergoing Transcatheter Aortic Valve Implantation), which is not on this map. Not yet cited in PubMed.
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Evaluation of the Effect of Ultrasound-guided PENG Block on Postoperative Analgesia Management in Patients Undergoing Transcatheter Aortic Valve Implantation: A Randomized, Prospective Study
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Abstract
backgroundAnesthesia management is crucial for elderly patients undergoing transcatheter aortic valve implantation (TAVI). Conscious sedation (CS) is often preferred, but additional methods need to be utilized. The Pericapsular nerve group (PENG) block is a regional anesthesia technique that provides analgesia in the hip and groin.
objectiveOur study aimed to investigate the role of PENG block in CS in patients undergoing TAVI. The primary outcome was the need for intraoperative additional fentanyl. Secondary outcomes included postoperative pain scores (NRS), rescue analgesia use (meperidine), and adverse events.
methodsPatients with American Society of Anesthesiologists physical status III-IV scheduled for elective TAVI under CS were enrolled in the study. The patients were randomized into two groups PENG group (n = 30) and local infiltration control group (n = 30). PENG block was performed with 30 ml of 0.25% bupivacaine 20 min before TAVI. Propofol infusion (1 mg/kg/hour) and fentanyl as a rescue regimen (1 mcg/kg) was used for CS.
resultsThe PENG group required significantly fewer additional doses of fentanyl for sedation and analgesia during the intraoperative period compared with the control group (70 [60-77.5] μg vs. 90 [60-140] μg, p = 0.001). The PENG group also had significantly lower pain scores at the first postoperative hour (NRS at rest, 0 (0-1) vs. 3 (2-3), p = 0.001) and reduced the need for postoperative rescue analgesia use (meperidine) (0 [0-0] mg vs. 35 [30-40] mg, p = 0.001).
conclusionThe PENG block provided effective analgesia and reduced the fentanyl requirement during TAVI under CS. The PENG block may be a beneficial choice to improve the quality of CS in these patients.
trial registrationNCT05904912.
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