Cuignet Olivier, Pirson Jean, Boughrouph Jenna, Duville Diane
*Burn Center, Queen Astrid Military Hospital, Military Medical Research Program and Development Committee, Brussels, Belgium, and the †Department of Anesthesiology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium.
Anesth Analg. 2004 Apr;98(4):1077-1081. doi: 10.1213/01.ANE.0000105863.04140.AE.
Postoperative pain from split skin donor sites is often more intense than the pain at the grafted site. In this prospective, randomized, double-blind study we assessed the efficacy of a continuous fascia iliaca compartment block (FICB) in reducing the pain at the thigh donor site. Twenty patients, with a total burn surface area of 16% +/- 13% (mean +/- SD) were randomized 1:1 to receive either ropivacaine 0.2% or saline 0.9%. All patients received a general anesthesic followed by preincision continuous FICB with 40 mL of the randomized solution, then an infusion of 10 mL/h of either ropivacaine or saline until the first dressing change (72 h later). Postoperative analgesia consisted of propacetamol 2g/6h, IV patient-controlled analgesia of morphine chlorhydrate (2 mg/mL), and morphine hydrochlorate 0.5 mg/kg PO once 60 min before first dressing change. The visual analog scale (VAS) scores were compared using the Mann-Whitney U-test preoperatively, 24 and 48 h postoperatively, and during the first dressing change. The cumulative morphine consumption was compared with repeated-measures analysis of variance followed by Scheffé's method if indicated. Patients with continuous FICB had significantly reduced postoperative morphine consumption at all time points (23 +/- 20 versus 88 +/- 29 mg after 72 h, study versus control groups, respectively; P < 0.05). In both groups, VAS scores remained low but were only significantly lower for patients with continuous FICB during the first dressing change (3 [1] versus 7 [3]; median [interquartile range]; P < 0.05). We conclude that continuous FICB is an efficient method for diminishing pain at the thigh donor site. (250 words)
Postoperative pain at the split skin donor sites is often more intense than the pain at the grafted site. This prospective, randomized, double-blind study assessed the efficacy of a continuous fascia iliaca compartment block in reducing the pain at the thigh donor site.
取自皮肤供区的术后疼痛通常比植皮部位的疼痛更为剧烈。在这项前瞻性、随机、双盲研究中，我们评估了持续髂筋膜室阻滞（FICB）对减轻大腿供区疼痛的疗效。20例患者，总体表面积为16%±13%（均值±标准差），按1:1随机分组，分别接受0.2%罗哌卡因或0.9%生理盐水。所有患者均接受全身麻醉，然后在切开前用40毫升随机分配的溶液进行持续FICB，随后以10毫升/小时的速度输注罗哌卡因或生理盐水，直至首次换药（72小时后）。术后镇痛包括静脉注射丙帕他莫2克/6小时、静脉自控镇痛用盐酸吗啡（2毫克/毫升），以及在首次换药前60分钟口服盐酸吗啡0.5毫克/千克。使用曼-惠特尼U检验比较术前、术后24小时和48小时以及首次换药期间的视觉模拟量表（VAS）评分。如有必要，采用重复测量方差分析及谢费方法比较累积吗啡消耗量。持续FICB组患者在所有时间点的术后吗啡消耗量均显著降低（72小时后分别为23±20毫克和88±29毫克，研究组与对照组；P<0.05）。两组患者的VAS评分均维持在较低水平，但仅在首次换药时，持续FICB组患者的VAS评分显著更低（3[1]比7[3]；中位数[四分位间距]；P<0.05）。我们得出结论，持续FICB是减轻大腿供区疼痛的有效方法。（250字）
取自皮肤供区的术后疼痛通常比植皮部位的疼痛更为剧烈。这项前瞻性、随机、双盲研究评估了持续髂筋膜室阻滞对减轻大腿供区疼痛的疗效。
