Comparison of analgesic effects of ultrasound-guided continuous iliac fasicia block using different approa-ches after total hip arthroplasty
- VernacularTitle:超声引导下不同入路持续髂筋膜阻滞对全髋关节置换术后镇痛效果的影响
- Author:
Xi WU
1
;
Bin YI
;
Ji LI
;
Xijian KE
;
Kun CHEN
;
Wei MEI
Author Information
1. 华中科技大学同济医学院附属同济医院麻醉科
- Keywords:
Postoperative analgesia;
Iliac fasicia block;
Total hip arthroplasty;
Ropivacaine
- From:
The Journal of Clinical Anesthesiology
2017;33(10):944-948
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the analgesic effect of continuous iliac fasicia block with dif-ferent approaches for patients undergoing total hip arthroplasty (THA).Methods Forty patients,21 males and 9 females,ASA physical status Ⅰ or Ⅱ,scheduled for elective hip arthroplasty surgery in Tongji Hospital from June to December 2016 were enrolled and randomly divided into two groups:parallel group (n =20)or vertical group (n =20).Patients received ultrasound-guided continuous iliac fasicia block with a short-axis in-plane technique in the parallel group and a long-axis in-plane tech-nique in the vertical group after the surgery.All patients had a 10 ml bolus of lidocaine 1% via the catheter followed by an infusion of ropivacaine 0.2% at 4 ml/h for 48 h.The ultrasound imaging time,procedure time and the depth of catheter were recorded.Cumulative frequency of patient-con-trolled nerve blockade analgesia (PCNA),ropivacaine consumption,pain scores at rest,the success rate of block,satisfaction scores and postoperative complications were recorded at every six hours during 48 h after the surgery.Results The ultrasound imaging time and procedure time in the vertical group were longer than in the parallel group (P <0.05).The depth of catheter in the vertical group was significantly greater than in the parallel group (P <0.05).The cumulative frequency of PCNA in the vertical group was significantly less than the parallel group (P <0.05 ).The success rate of the lateral femoral cutaneous nerve block in the vertical group was significantly higher than the parallel group at 6,12,18,24,30,36,42,48 h.The cumulative ropivacaine consumption at 24,30,36 h in the vertical group was significantly less compared with the parallel group (P <0.05).The pain inten-sity at rest was less in the vertical group compared with the parallel group at 24,30,36,42,48 h (P<0.05).There were no significant differences in the success rate of the femoral nerve block,satisfac-tion scores and related complications between the two groups.Conclusion Continuous iliac fasicia block with the short-axis in-plane and long-axis in-plane technique can effectively provide the postop-erative analgesic effects for patients undergoing THA.The long-axis in-plane technique in the vertical group with a higher success rate of the lateral femoral cutaneous nerve block can significantly reduce the ropivacaine consumption and pain scores.
