Comparison of different approaches to fascia iliaca compartment block for postoperative analgesia in elderly patients undergoing total hip arthroplasty
10.3760/cma.j.issn.0254-1416.2019.10.019
- VernacularTitle: 不同入路髂筋膜间隙阻滞用于全髋关节置换术老年患者术后镇痛效果的比较
- Author:
Jian YU
1
;
Chunhua ZHU
;
Yajun JI
;
Yingkai QI
;
Yu NIE
Author Information
1. Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou 061000, China
- Publication Type:Journal Article
- Keywords:
Analgesia;
Fascia iliaca compartment block;
Hip, arthroplasty;
Aged
- From:
Chinese Journal of Anesthesiology
2019;39(10):1224-1227
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of ultrasound-guided fascia iliaca compartment block(FICB) above inguinal ligament and longitudinal inguinal FICB for postoperative analgesia in elderly patients undergoing total hip arthroplasty (THA).
Methods:Sixty American Society of Anesthesiologists physical statusⅠ orⅡ patients of both sexes, aged 65-76 yr, with body mass index of 19-26 kg/m2, scheduled for elective unilateral THA, were divided into 2 groups (n=30 each) using a random number table method: FICB above inguinal ligament group (S group) or longitudinal inguinal FICB group (G group). After the end of surgery, patients received ultrasound-guided FICB using a short-axis in-plane technique in S group and longitudinal inguinal FICB using a long-axis in-plane technique in G group, and patients received 0.4% ropivacaine as a loading dose of 40 ml, followed by continuous infusion of 0.2% ropivacaine 5 ml/h for 48 h. Ultrasound imaging time, puncture injection time and operating time of FICB were recorded.The efficacy of nerve block, effective pressing times, cumulative consumption of ropivacaine, satisfaction with analgesia, and development of related complications were recorded at 6, 12, 24, 36, 48 and 72 h after surgery (T1-6).
Results:Compared with group G, the requirement for rescue analgesia with dezocine was significantly decreased, the effective pressing times at T3-5 and cumulative consumption of ropivacaine at T3, 4 were reduced, and the success rate of obturator nerve block was increased at T1-6 in group S (P<0.05). There were no significant differences in the success rate of the femoral nerve and lateral femoral cutaneous nerve block, satisfaction with analgesia and development of related complications between the two groups (P>0.05).
Conclusion:Ultrasound-guided FICB above inguinal ligament increases the success rate of the obturator nerve block, provides better efficacy for postoperative analgesia and is more helpful for early postoperative functional exercise and recovery than the longitudinal inguinal FICB in the patients undergoing THA.
