Применение блокады подвздошной фасции и блокады перикапсулярной группы нервов в рамках мультимодальной анальгезии после первичного эндопротезирования тазобедренного сустава (обзор литературы)

Введение. В настоящее время эндопротезирование тазобедренного сустава является стандартом лечения терминальных стадий деформирующего артроза, при этом данный вид хирургического лечения ассоциирован с развитием интенсивного послеоперационного болевого синдрома. Современные подходы к обезболиванию базируются на принципе мультимодальной анальгезии, в рамках которого широко применяются различные методы местной анестезии. Современное развитие ультразвуковых технологий и их внедрение в анестезиологическую практику существенно повысило безопасность и эффективность периферических блокад. В обзоре обсуждается клиническая эффективность двух популярных периферических блокад, используемых в мультимодальных схемах анальгезии: блокада подвздошной фасции (FIBS) и блокада перикапсулярной группы нервов (PENG).

Материалы и методы. Поиск публикаций (1973–2024 гг.) проводили в базах данных eLibrary.ru, PubMed, Google Scholar. Всего было включено 50 публикаций, из них 45 – клинические исследования.

Заключение. Современные данные в целом подтверждают эффективность использования таких методов регионарной анестезии, как FICB и блокада PENG, в рамках мультимодальной анальгезии у пациентов после первичного ЭТБС. Такой подход обеспечивает опиоидсберегающий эффект, снижает риск различных осложнений и способствует ранней мобилизации. Однако в настоящее время данных недостаточно для того, чтобы дать четкие рекомендации по большинству аспектов применения этих блокад.

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