Analgesic efficacy of supra-inguinal fascia iliac compartment block in patients with hip fracture
10.3760/cma.j.cn131073.20240507.01210
- VernacularTitle:腹股沟韧带上髂筋膜间隙阻滞用于髋部骨折患者镇痛的效果
- Author:
Hao ZHONG
1
;
Xinyi WANG
;
Qin QIN
;
Fuling ZHANG
;
Hao SUN
;
Youjia YU
;
Yan LI
;
Jiang ZHU
Author Information
1. 苏州大学附属第二医院麻醉科，苏州 215000
- Publication Type:Journal Article
- Keywords:
Ilium;
Fascia;
Nerve block;
Analgesia;
Hip fractures
- From:
Chinese Journal of Anesthesiology
2024;44(12):1450-1455
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the analgesic efficacy of supra-inguinal fascia iliac compartment block (S-FICB)in patients with hip fracture.Methods:This study was a single-center, randomized controlled trial. Forty-eight patients who were admitted to the emergency department due to clinically diagnosed femoral neck or intertrochanteric fractures from April to September 2023 were selected. A random sequence was generated using IBM SPSS Statistics 20, and the patients were divided into 2 groups in a 1∶1 ratio( n=24 each): S-FICB group and infra-inguinal fascia iliac compartment block (I-FICB) group. Both groups received nerve blocks under ultrasound guidance, with an injection of 0.25% ropivacaine 40 ml. The primary outcome measure was sufentanil consumption within 24 h post-block. Secondary outcome measures included the distribution of local anesthetic spread as observed on CT at 0.5 h post-block, the extent of hip skin sensory reduction to pinprick, the time to first analgesic pump pressing, the number of effective analgesic pump pressing within 24 h post-block, the Numeric Rating Scale (NRS) score for pain during passive movement at 0.5 h post-block, and the static NRS scores at baseline (pre-block) and at 0.5, 3, 6, 12 and 24 h post-block. Results:Compared to I-FICB group, the consumption of sufentanil was significantly decreased, the coverage of lumbar plexus nerve branches by local anesthetics was increased, NRS scores were decreased during passive movement, the time to the first analgesic pump pressing was prolonged, the number of effective pump pressing was reduced, and static NRS scores were decreased at 24 h post-block in S-FICB group( P<0.01). In I-FICB group, no local anesthetic coverage of the iliohypogastric or ilioinguinal nerves was observed. Neither group showed coverage of the obturator nerve by the local anesthetic. Conclusions:Compared to I-FICB, S-FICB (0.25% ropivacaine 40 ml) provides a wider range of local anesthetic spread and can cover more branches of the lumbar plexus, which exerts better analgesic efficacy in patients with hip fracture. However, neither approach directly blocks the obturator nerve.
