Ultrasound-guided continuous fascia iliaca compartment block for perioperative pain management in elderly patients undergoing hip fracture surgery.
10.12200/j.issn.1003-0034.2023.11.008
- Author:
Chun-Xiu LI
1
;
Wen-Chao GE
2
;
Kang-Ning YANG
1
;
Hua-Yong ZHENG
3
;
Xiao-Wei WANG
3
;
Ye-Lai WANG
3
;
Jie GAO
4
;
Wen-Zhi GUO
5
Author Information
1. Department of Anesthesiology, Shanxi Medical University, Taiyuan 030000, Shanxi, China.
2. Graduate School of North China University of Science and Technology, Tangshan 063210, Hebei, China; Department of Anesthesiology, the 7th Medical Center of PLA General Hospital, Beijing 100700, China.
3. The 7th Medical Center of PLA General Hospital, Beijing 100700, China.
4. Department of Orthopedics Medicine, the 4th Medical Center of PLA General Hospital, Beijing 100048, China.
5. Department of Anesthesiology, Shanxi Medical University, Taiyuan 030000, Shanxi, China; Department of Anesthesiology, the 7th Medical Center of PLA General Hospital, Beijing 100700, China.
- Publication Type:Journal Article
- Keywords:
Continuous fascia iliaca compartment block;
Elderly patients;
Hip fracture;
Perioperative analgesia
- MeSH:
Male;
Female;
Humans;
Aged;
Aged, 80 and over;
Pain Management;
Nerve Block;
Quality of Life;
Hip Fractures/surgery*;
Pain/surgery*;
Femoral Neck Fractures/surgery*;
Femoral Fractures/surgery*;
Ultrasonography, Interventional;
Postoperative Complications/surgery*;
Fascia;
Pain, Postoperative
- From:
China Journal of Orthopaedics and Traumatology
2023;36(11):1046-1051
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To study the effect of ultrasound-guided fascia iliaca compartment block on perioperative analgesia and postoperative complications in geriatric patients with hip fractures.
METHODS:A total of 127 elderly patients undergoing hip fracture surgery from January 2021 to September 2021 were randomized to receive ultrasound-guided continuous fascia iliaca compartment block(group F) either intravenous analgesia control group(group C). There were 62 cases in group F, including 19 males and 43 females with an average age of (82.4±7.2) years old ranging from 66 to 95 years old, involving 25 femoral neck fractures and 37 femoral intertrochanteric fractures. There were 65 cases in control group, including 18 males and 47 females, with an average age of (81.4±8.7) years old ranging from 65 to 94 years old, involving 29 femoral neck fractures and 36 femoral intertrochanteric fractures. The visual analogue scale(VAS), minimental state examination (MMSE), observer's assessment of alertness/sedation(OAA/S) scale, modified Bromage score, postoperative complications and general conditions during hospitalization in two groups were observed.
RESULTS:The resting and exercise VAS at 30 min after block, anesthesia placement and 6, 24 and 48 h after surgery were lower than those in group C(P<0.05). In group F, MMSE scores at 12 h before surgery, and 1, 3 d after surgery and OAA/S scores at 3 d after surgery were higher than those in group C(P<0.05). The incidence of adverse effects and the number requiring additional analgesia were lower than those in group C(P<0.05). Group F had better perioperative analgesia satisfaction and hospital stay than group C(P<0.05). But there was no significant difference regarding Bromage score and 30-day mortality between two group(P>0.05).
CONCLUSION:Ultrasound-guided continuous fascia iliacus space block was safe and effective for elderly patients with hip fracture, and could significantly reduce perioperative pain, improve postoperative cognitive function, and reduce postoperative complications, thereby shortening hospital stay and improving the quality of life during hospitalization.
