BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pa...BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.展开更多
BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique tha...BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique that is easy to implement.Here,we report a case of fascia iliaca compartment block in a patient with myocardial infarction who underwent emergency middle thigh amputation.CASE SUMMARY A 78-year-old female patient weighing 38 kg with gangrene and occlusive peripheral atherosclerosis of the right leg underwent an emergency middle thigh amputation.The patient had a history of hypertension,coronary heart disease,cerebral infarction,anterior wall myocardial infarction,and had recently undergone percutaneous coronary intervention consisting of coronary angiography and right coronary artery stent implantation.Considering the patient's condition,an ultrasound-guided fascia iliaca compartment block combined with general anesthesia was implemented for amputation.The fascia iliaca compartment block provided analgesia for the operation,and reduced the dosage of general anesthetics.It also alleviated adverse cardiovascular effects caused by pain stress,and ensured the safety of the patient during the perioperative period.This block also provided postoperative analgesia.The patient had a good prognosis,and was subsequently discharged from hospital.CONCLUSION Fascia iliaca compartment block provides surgical analgesia.It also alleviates adverse cardiovascular effects,and ensures patient safety during the perioperative period.展开更多
BACKGROUND Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients undergoing total hip arthroplasty.AIM To investigate whether ultrasound-guided,direct...BACKGROUND Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients undergoing total hip arthroplasty.AIM To investigate whether ultrasound-guided,direct suprainguinal injection for fascia iliaca block accelerated recovery after general anesthesia and relieved postoperative pain after total hip arthroplasty.METHODS Patients who underwent total hip arthroplasty under general anesthesia in 2015 or 2019 at The Second Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.The patients were grouped based on whether preoperative suprainguinal fascia iliaca block was performed or not.The time to tracheal extubation and time spent in the post-anesthesia care unit(PACU),intraoperative remifentanil dosage,fentanyl consumption in the PACU,postoperative cumulative fentanyl consumption within 48 h after operation,visual analogue scale at rest and during movement on the first and second days after surgery,and adverse reactions were compared.RESULTS Thirty-one elderly patients who underwent total hip arthroplasty were included in the study(block group,n=16;no-block group,n=15).The visual analog scale scores at rest and during movement on the first and second days were significantly lower in the block group than in the no-block group(all P<0.05).Compared with the no-block group,the intraoperative remifentanil dosage was lower,the time to tracheal extubation and the time spent in the PACU were shorter in the block group(all P<0.01).Fentanyl consumption in the PACU and postoperative cumulative fentanyl consumption in 48 h after operation were lower in the block group(all P<0.01).The incidence of dizziness was higher in the no-block group than in the block group(P=0.037).CONCLUSION Ultrasound-guided,direct suprainguinal injection for fascia iliaca block led to faster recovery after general anesthesia and early postoperative pain relief in elderly patients undergoing total hip arthroplasty.展开更多
BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.CASE SUMMARY Th...BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.CASE SUMMARY This report established that hip surgical procedures can be performed with a fascia iliaca compartment block(FICB)and monitored anesthesia care(MAC)while avoiding neuraxial or general anesthesia.This was a preliminary experience with two geriatric patients with hip fracture,American Society of Anesthesiologists status III,and with many comorbidities.Neither patient could be operated on within 48 h after admission.Both general anesthesia and neuraxial anesthesia were high-risk procedures and had contraindications.Hence,we chose nerve block combined with a small amount of sedation.Intraoperative analgesia was provided by single-injection ultrasound-guided FICB.Light intravenous sedation was added.Surgical exposure was satisfactory,and neither patient complained of any symptoms during the procedure.CONCLUSION This report showed that hip surgery for geriatric patients can be performed with FICB and MAC,although complications and contraindications are common.The anesthetic program was accompanied by stable respiratory and circulatory system responses and satisfactory analgesia while avoiding the adverse effects and problems associated with either neuraxial or general anesthesia.展开更多
BACKGROUND Fascia iliaca compartment blocks(FIBs) have been used to provide postoperative analgesia after total hip arthroplasty(THA). However, evidence of their efficacy remains limited. While pain control appears to...BACKGROUND Fascia iliaca compartment blocks(FIBs) have been used to provide postoperative analgesia after total hip arthroplasty(THA). However, evidence of their efficacy remains limited. While pain control appears to be satisfactory, quadriceps weakness may be an untoward consequence of the block. Prior studies have shown femoral nerve blocks and fascia iliaca blocks as being superior for pain control and ambulation following THA when compared to standard therapy of parenteral pain control. However, most studies allowed patients to ambulate on post-operative day(POD) 2-3, whereas new guidelines suggest ambulation on POD 0 is beneficial.AIM To determine the effect of FIB after THA in patients participating in an enhanced recovery after surgery(ERAS) program.METHODS We conducted a retrospective analysis of patients undergoing THA with or without FICBs and their ability to ambulate on POD 0 in accordance with ERAS protocol. Perioperative data was collected on 39 patients who underwent THA.Demographic data, anesthesia data, and ambulatory outcomes were compared.RESULTS Twenty patients had FIBs placed at the conclusion of the procedure, while 19 did not receive a block. Of the 20 patients with FIB, only 1 patient was able to ambulate. Of the 19 patients without FIB blocks, 17 were able to ambulate. All patients worked with physical therapy 2 h after arriving in the post-anesthesia care unit on POD 0.CONCLUSION Our data suggests an association between FIB and delayed ambulation in the immediate post-operative period.展开更多
<b>Purpose:</b> The purpose of the study is to evaluate the analgesic effect of adding magnesium sulfate to bupivacaine in Fascia Iliaca Compartment Block (FI-CB). <b>Patients and Methods:</b> ...<b>Purpose:</b> The purpose of the study is to evaluate the analgesic effect of adding magnesium sulfate to bupivacaine in Fascia Iliaca Compartment Block (FI-CB). <b>Patients and Methods:</b> Ninety-six burn patients scheduled for skin-grafting procedures were allocated into two equal groups. After induction of general anaethesia, forty-eight patients received <b>US guided</b> FICB using 35 ml bupivacaine 0.25% + 5 ml isotonic sodium chloride solution with a total volume of 40 ml. The other forty-eight patients received 35 ml bupivacaine 0.25% + 250 mg of magnesium sulfate with a total volume of 40 ml. <b>Results:</b> Total postoperative pethidine consumption in the first 24 h post-operative showed a highly statistically significant decrease in the magnesium group in comparison to the bupivacaine group. <b>Conclusion:</b> Adding magnesium sulfate to bupivacaine in FICB in skin grafting procedures decreased the pain scores post-operative, delayed the first request of analgesia and reduced the total analgesic consumption in the first 24 h post-operative without any significant side effects.展开更多
<b>Introduction:</b> Regional anaesthesia techniques have been used for perioperative analgesia for hip fractures. The supra-inguinal approach to fascia iliaca block (FIB) can potentially provide superior ...<b>Introduction:</b> Regional anaesthesia techniques have been used for perioperative analgesia for hip fractures. The supra-inguinal approach to fascia iliaca block (FIB) can potentially provide superior analgesia compared to femoral nerve block (FNB) by blocking the obturator and lateral femoral cutaneous nerves. We aimed to evaluate the analgesic effect of single shot FIB and FNB for surgical fixation of hip fractures. <b>Methods:</b> After obtaining ethics approval and written, informed consent, 30 patients undergoing surgical fixation of hip fractures were recruited and randomized into 2 groups. Patients received either a single shot FIB or FNB with 0.5% Ropivacaine 30 mls, and a subarachnoid block. Pain scores were assessed pre-operatively, post-block, in recovery and at 24 hours post-operatively. Time to first analgesic, oxynorm consumption, opioid related side effects and block related complications were assessed at 24 hours. <b>Results:</b> There were no statistically significant difference in post-block pain scores, median (IQR) of 0 (0 - 0) versus 0 (0 - 0) at rest and 3 (2 - 6) versus 5 (2 - 6) on positioning for spinal;and 24 hour pain scores were 0 (0 - 0) versus 0 (0 - 0) at rest and 4 (2 - 5) versus 5 (2 - 6) on movement for FIB and FNB groups respectively. 5 patients from each group required post-operative opioids, post-operative opioids requirement were similar. <b>Conclusions:</b> Though ultrasound guided supra-inguinal FIB was more consistent in blocking the lateral femoral cutaneous nerve then a femoral nerve block, this did not translate to any difference in terms of pain scores, opioid consumption and side effects.展开更多
Objective:To investigate the effect of fascia iliaca compartment block combined with general anesthesia on the pain and inflammatory stress mediator secretion after hip replacement. Methods: A total of 170 patients wi...Objective:To investigate the effect of fascia iliaca compartment block combined with general anesthesia on the pain and inflammatory stress mediator secretion after hip replacement. Methods: A total of 170 patients with femoral neck fracture who underwent hip replacement in this hospital between September 2015 and August 2017 were divided into the control group (n=103) who underwent routine general anesthesia and the study group (n=67) who underwent fascia iliaca compartment block combined with general anesthesia after the anesthetic solutions were reviewed. The differences in serum contents of pain mediators, inflammatory factors and stress hormones were compared between the two groups of patients immediately after surgery as well as 12 h and 24 h after surgery.Results: Immediately after surgery, there was no statistically significant difference in serum contents of pain mediators, inflammatory factors and stress hormones between the two groups. 12 h and 24 h after surgery, serum pain mediators NPY, PGE2, 5-HT,β-EP and SP contents of study group were lower than those of control group;serum inflammatory factors CRP, TNF-α and IL-1β contents were lower than those of control group;serum stress hormones Cor, CA and ACTH contents were lower than those of control group.Conclusion: fascia iliaca compartment block combined with general anesthesia can effectively reduce the postoperative pain as well as the systemic inflammatory response and stress response induced by pain in patients with hip replacement.展开更多
Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly ...Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly patients who received hip replacement in Mianyang Central Hospital between December 2015 and June 2017 were selected and randomly divided into multimodal analgesia group (MMA group), and patient-controlled intravenous analgesia group (PCIA group), MMA received ropivacaine fascia iliaca compartment block, dezocine preemptive analgesia combined with patient-controlled intravenous analgesia, and PCAI group received patient-controlled intravenous analgesia. The levels of pain-related molecules and stress-related hormones in serum as well as the levels of stress-related immune molecules in peripheral blood were detected immediately after surgery and 12 h after surgery. Results: 12 h after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of both groups of patients were significantly higher than those immediately after surgery, peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly lower than those immediately after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of MMA group 12 h after surgery were significantly lower than those of PCIA group, and peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly higher than those of PCIA group. Conclusion: Ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia can reduce the pain and stress response after hip replacement.展开更多
[目的]比较髋关节置换术(total hip arthroplasty,THA)腰丛阻滞(lumbar plexus block,LPB)与改良高位髂筋膜间隙阻滞(improved high fascia iliaca compartment block,IHFICB)两种阻滞的镇痛效果。[方法]2022年3月—2023年10月210例髋...[目的]比较髋关节置换术(total hip arthroplasty,THA)腰丛阻滞(lumbar plexus block,LPB)与改良高位髂筋膜间隙阻滞(improved high fascia iliaca compartment block,IHFICB)两种阻滞的镇痛效果。[方法]2022年3月—2023年10月210例髋部疾病患者在腰麻下进行THA术,抛硬币法分为两组,102例采用LPB(LPB组),108例采用IHFICB(IHFICB组),比较两组临床与镇痛资料。[结果]LPB组阻滞操作时间长于IHFICB组[(14.5±5.5)min vs(8.4±3.8)min,P<0.001],但前者阻滞见效时间早于后者[(9.2±2.4)min vs(12.6±3.0)min,P<0.001]。两组在手术时间、术中失血量、住院时间、下床行走时间、总不良反应发生率、术后完全负重行走时间、术后Harris评分的差异均无统计学意义(P>0.05)。镇痛方面,两组首次使用镇痛泵时间、使用镇痛泵次数、补救镇痛人数、术后VAS的评分差异均无统计学意义(P>0.05)。[结论]THA术LPB与IHFICB均能获得良好且满意的镇痛效果,但LPB阻滞见效更快,IHFICB阻滞操作时间更短。展开更多
文摘BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.
文摘BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique that is easy to implement.Here,we report a case of fascia iliaca compartment block in a patient with myocardial infarction who underwent emergency middle thigh amputation.CASE SUMMARY A 78-year-old female patient weighing 38 kg with gangrene and occlusive peripheral atherosclerosis of the right leg underwent an emergency middle thigh amputation.The patient had a history of hypertension,coronary heart disease,cerebral infarction,anterior wall myocardial infarction,and had recently undergone percutaneous coronary intervention consisting of coronary angiography and right coronary artery stent implantation.Considering the patient's condition,an ultrasound-guided fascia iliaca compartment block combined with general anesthesia was implemented for amputation.The fascia iliaca compartment block provided analgesia for the operation,and reduced the dosage of general anesthetics.It also alleviated adverse cardiovascular effects caused by pain stress,and ensured the safety of the patient during the perioperative period.This block also provided postoperative analgesia.The patient had a good prognosis,and was subsequently discharged from hospital.CONCLUSION Fascia iliaca compartment block provides surgical analgesia.It also alleviates adverse cardiovascular effects,and ensures patient safety during the perioperative period.
文摘BACKGROUND Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients undergoing total hip arthroplasty.AIM To investigate whether ultrasound-guided,direct suprainguinal injection for fascia iliaca block accelerated recovery after general anesthesia and relieved postoperative pain after total hip arthroplasty.METHODS Patients who underwent total hip arthroplasty under general anesthesia in 2015 or 2019 at The Second Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.The patients were grouped based on whether preoperative suprainguinal fascia iliaca block was performed or not.The time to tracheal extubation and time spent in the post-anesthesia care unit(PACU),intraoperative remifentanil dosage,fentanyl consumption in the PACU,postoperative cumulative fentanyl consumption within 48 h after operation,visual analogue scale at rest and during movement on the first and second days after surgery,and adverse reactions were compared.RESULTS Thirty-one elderly patients who underwent total hip arthroplasty were included in the study(block group,n=16;no-block group,n=15).The visual analog scale scores at rest and during movement on the first and second days were significantly lower in the block group than in the no-block group(all P<0.05).Compared with the no-block group,the intraoperative remifentanil dosage was lower,the time to tracheal extubation and the time spent in the PACU were shorter in the block group(all P<0.01).Fentanyl consumption in the PACU and postoperative cumulative fentanyl consumption in 48 h after operation were lower in the block group(all P<0.01).The incidence of dizziness was higher in the no-block group than in the block group(P=0.037).CONCLUSION Ultrasound-guided,direct suprainguinal injection for fascia iliaca block led to faster recovery after general anesthesia and early postoperative pain relief in elderly patients undergoing total hip arthroplasty.
文摘BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.CASE SUMMARY This report established that hip surgical procedures can be performed with a fascia iliaca compartment block(FICB)and monitored anesthesia care(MAC)while avoiding neuraxial or general anesthesia.This was a preliminary experience with two geriatric patients with hip fracture,American Society of Anesthesiologists status III,and with many comorbidities.Neither patient could be operated on within 48 h after admission.Both general anesthesia and neuraxial anesthesia were high-risk procedures and had contraindications.Hence,we chose nerve block combined with a small amount of sedation.Intraoperative analgesia was provided by single-injection ultrasound-guided FICB.Light intravenous sedation was added.Surgical exposure was satisfactory,and neither patient complained of any symptoms during the procedure.CONCLUSION This report showed that hip surgery for geriatric patients can be performed with FICB and MAC,although complications and contraindications are common.The anesthetic program was accompanied by stable respiratory and circulatory system responses and satisfactory analgesia while avoiding the adverse effects and problems associated with either neuraxial or general anesthesia.
文摘BACKGROUND Fascia iliaca compartment blocks(FIBs) have been used to provide postoperative analgesia after total hip arthroplasty(THA). However, evidence of their efficacy remains limited. While pain control appears to be satisfactory, quadriceps weakness may be an untoward consequence of the block. Prior studies have shown femoral nerve blocks and fascia iliaca blocks as being superior for pain control and ambulation following THA when compared to standard therapy of parenteral pain control. However, most studies allowed patients to ambulate on post-operative day(POD) 2-3, whereas new guidelines suggest ambulation on POD 0 is beneficial.AIM To determine the effect of FIB after THA in patients participating in an enhanced recovery after surgery(ERAS) program.METHODS We conducted a retrospective analysis of patients undergoing THA with or without FICBs and their ability to ambulate on POD 0 in accordance with ERAS protocol. Perioperative data was collected on 39 patients who underwent THA.Demographic data, anesthesia data, and ambulatory outcomes were compared.RESULTS Twenty patients had FIBs placed at the conclusion of the procedure, while 19 did not receive a block. Of the 20 patients with FIB, only 1 patient was able to ambulate. Of the 19 patients without FIB blocks, 17 were able to ambulate. All patients worked with physical therapy 2 h after arriving in the post-anesthesia care unit on POD 0.CONCLUSION Our data suggests an association between FIB and delayed ambulation in the immediate post-operative period.
文摘<b>Purpose:</b> The purpose of the study is to evaluate the analgesic effect of adding magnesium sulfate to bupivacaine in Fascia Iliaca Compartment Block (FI-CB). <b>Patients and Methods:</b> Ninety-six burn patients scheduled for skin-grafting procedures were allocated into two equal groups. After induction of general anaethesia, forty-eight patients received <b>US guided</b> FICB using 35 ml bupivacaine 0.25% + 5 ml isotonic sodium chloride solution with a total volume of 40 ml. The other forty-eight patients received 35 ml bupivacaine 0.25% + 250 mg of magnesium sulfate with a total volume of 40 ml. <b>Results:</b> Total postoperative pethidine consumption in the first 24 h post-operative showed a highly statistically significant decrease in the magnesium group in comparison to the bupivacaine group. <b>Conclusion:</b> Adding magnesium sulfate to bupivacaine in FICB in skin grafting procedures decreased the pain scores post-operative, delayed the first request of analgesia and reduced the total analgesic consumption in the first 24 h post-operative without any significant side effects.
文摘<b>Introduction:</b> Regional anaesthesia techniques have been used for perioperative analgesia for hip fractures. The supra-inguinal approach to fascia iliaca block (FIB) can potentially provide superior analgesia compared to femoral nerve block (FNB) by blocking the obturator and lateral femoral cutaneous nerves. We aimed to evaluate the analgesic effect of single shot FIB and FNB for surgical fixation of hip fractures. <b>Methods:</b> After obtaining ethics approval and written, informed consent, 30 patients undergoing surgical fixation of hip fractures were recruited and randomized into 2 groups. Patients received either a single shot FIB or FNB with 0.5% Ropivacaine 30 mls, and a subarachnoid block. Pain scores were assessed pre-operatively, post-block, in recovery and at 24 hours post-operatively. Time to first analgesic, oxynorm consumption, opioid related side effects and block related complications were assessed at 24 hours. <b>Results:</b> There were no statistically significant difference in post-block pain scores, median (IQR) of 0 (0 - 0) versus 0 (0 - 0) at rest and 3 (2 - 6) versus 5 (2 - 6) on positioning for spinal;and 24 hour pain scores were 0 (0 - 0) versus 0 (0 - 0) at rest and 4 (2 - 5) versus 5 (2 - 6) on movement for FIB and FNB groups respectively. 5 patients from each group required post-operative opioids, post-operative opioids requirement were similar. <b>Conclusions:</b> Though ultrasound guided supra-inguinal FIB was more consistent in blocking the lateral femoral cutaneous nerve then a femoral nerve block, this did not translate to any difference in terms of pain scores, opioid consumption and side effects.
文摘Objective:To investigate the effect of fascia iliaca compartment block combined with general anesthesia on the pain and inflammatory stress mediator secretion after hip replacement. Methods: A total of 170 patients with femoral neck fracture who underwent hip replacement in this hospital between September 2015 and August 2017 were divided into the control group (n=103) who underwent routine general anesthesia and the study group (n=67) who underwent fascia iliaca compartment block combined with general anesthesia after the anesthetic solutions were reviewed. The differences in serum contents of pain mediators, inflammatory factors and stress hormones were compared between the two groups of patients immediately after surgery as well as 12 h and 24 h after surgery.Results: Immediately after surgery, there was no statistically significant difference in serum contents of pain mediators, inflammatory factors and stress hormones between the two groups. 12 h and 24 h after surgery, serum pain mediators NPY, PGE2, 5-HT,β-EP and SP contents of study group were lower than those of control group;serum inflammatory factors CRP, TNF-α and IL-1β contents were lower than those of control group;serum stress hormones Cor, CA and ACTH contents were lower than those of control group.Conclusion: fascia iliaca compartment block combined with general anesthesia can effectively reduce the postoperative pain as well as the systemic inflammatory response and stress response induced by pain in patients with hip replacement.
文摘Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly patients who received hip replacement in Mianyang Central Hospital between December 2015 and June 2017 were selected and randomly divided into multimodal analgesia group (MMA group), and patient-controlled intravenous analgesia group (PCIA group), MMA received ropivacaine fascia iliaca compartment block, dezocine preemptive analgesia combined with patient-controlled intravenous analgesia, and PCAI group received patient-controlled intravenous analgesia. The levels of pain-related molecules and stress-related hormones in serum as well as the levels of stress-related immune molecules in peripheral blood were detected immediately after surgery and 12 h after surgery. Results: 12 h after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of both groups of patients were significantly higher than those immediately after surgery, peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly lower than those immediately after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of MMA group 12 h after surgery were significantly lower than those of PCIA group, and peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly higher than those of PCIA group. Conclusion: Ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia can reduce the pain and stress response after hip replacement.
文摘[目的]比较髋关节置换术(total hip arthroplasty,THA)腰丛阻滞(lumbar plexus block,LPB)与改良高位髂筋膜间隙阻滞(improved high fascia iliaca compartment block,IHFICB)两种阻滞的镇痛效果。[方法]2022年3月—2023年10月210例髋部疾病患者在腰麻下进行THA术,抛硬币法分为两组,102例采用LPB(LPB组),108例采用IHFICB(IHFICB组),比较两组临床与镇痛资料。[结果]LPB组阻滞操作时间长于IHFICB组[(14.5±5.5)min vs(8.4±3.8)min,P<0.001],但前者阻滞见效时间早于后者[(9.2±2.4)min vs(12.6±3.0)min,P<0.001]。两组在手术时间、术中失血量、住院时间、下床行走时间、总不良反应发生率、术后完全负重行走时间、术后Harris评分的差异均无统计学意义(P>0.05)。镇痛方面,两组首次使用镇痛泵时间、使用镇痛泵次数、补救镇痛人数、术后VAS的评分差异均无统计学意义(P>0.05)。[结论]THA术LPB与IHFICB均能获得良好且满意的镇痛效果,但LPB阻滞见效更快,IHFICB阻滞操作时间更短。
