Archive | 2019
Comparison of different approaches to fascia iliaca compartment block for postoperative analgesia in elderly patients undergoing total hip arthroplasty
Abstract
Objective \nTo 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). \n \n \nMethods \nSixty American Society of Anesthesiologists physical statusâ… orâ…ˇ 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). \n \n \nResults \nCompared 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). \n \n \nConclusion \nUltrasound-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. \n \n \nKey words: \nAnalgesia;\xa0Fascia iliaca compartment block;\xa0Hip, arthroplasty;\xa0Aged