Background: Animal and other experimental studies have demonstrated increased block time and quality when α- and β-cyclodextrin drugs are combined with local anesthetics. However, to our knowledge, no study has utilized γ-cyclodextrins in such a combination. In the present study, we used an animal model to evaluate the effects of different doses of the combined administration of γ-cyclodextrin (sugammadex) and bupivacaine on the duration of sciatic nerve blocks in rats. Methods: Sciatic nerve blocks were performed with a 0.20 ml mixture in all groups. For the non-experimental groups, this mixture consisted of 0.2 ml saline (Sham group), 0.2 ml sugammadex (Group S), or 0.16 ml bupivacaine 0.5% and 0.04 ml saline (Group B). For the experimental groups, 0.16 ml bupivacaine 0.5% was administered along with 0.01 ml sugammadex and 0.03 ml saline (Group BS1), 0.02 ml sugammadex and 0.02 ml saline (Group BS2), or 0.04 ml sugammadex (Group BS4). Proprioception, nociception, and motor function were evaluated until the sciatic block was completely reversed. Results: Motor, proprioceptive, and nociceptive blockades occurred within 5 min in all experimental groups. In Group BS4, the duration of the motor, proprioceptive, and nociceptive blockades was significantly increased compared with the other experimental groups. However, in Groups BS1 and BS2, only the duration of the nociceptive blockade was significantly increased. Conclusions The combined administration of sugammadex and bupivacaine for sciatic nerve blocks in rats led to a significant increase in the duration of motor, proprioceptive, and nociceptive blockades.

Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen’s d = 4.62), and IAI group at 4 (Cohen’s d = 5.15) and 8 (Cohen’s d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen’s d = 2.16, P = 0.007) and WOMAC (Cohen’s d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.

Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291–16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038–4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405–5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124–0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.