Haines Lawrence, Dickman Eitan, Ayvazyan Sergey, Pearl Michelle, Wu Stanley, Rosenblum David, Likourezos Antonios
Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York 11209, USA.
J Emerg Med. 2012 Oct;43(4):692-7. doi: 10.1016/j.jemermed.2012.01.050. Epub 2012 Apr 9.
Hip fracture (HFx) is a painful injury that is commonly seen in the emergency department (ED). Patients who experience pain from HFx are often treated with intravenous opiates, which may cause deleterious side effects, particularly in elderly patients. An alternative to systemic opioid analgesia involves peripheral nerve blockade. This approach may be ideally suited for the ED environment, where one injection could control pain for many hours.
We hypothesized that an ultrasound-guided fascia iliaca compartment block (UFIB) would provide analgesia for patients presenting to the ED with pain from HFx and that this procedure could be performed safely by emergency physicians (EP) after a brief training.
In this prospective, observational, feasibility study, a convenience sample of 20 cognitively intact patients with isolated HFx had a UFIB performed. Numerical pain scores, vital signs, and side effects were recorded before and after administration of the UFIB at pre-determined time points for 8h.
All patients reported decreased pain after the nerve block, with a 76% reduction in mean pain score at 120 min. There were no procedural complications.
In this small group of ED patients, UFIB provided excellent analgesia without complications and may be a useful adjunct to systemic pain control for HFx.
髋部骨折（HFx）是急诊科常见的疼痛性损伤。因髋部骨折而疼痛的患者通常接受静脉注射阿片类药物治疗，这可能会导致有害的副作用，尤其是在老年患者中。全身阿片类镇痛的替代方法是外周神经阻滞。这种方法可能非常适合急诊科环境，一次注射就能控制疼痛数小时。
我们假设超声引导下的髂筋膜室阻滞（UFIB）可为因髋部骨折疼痛而就诊于急诊科的患者提供镇痛，并且在经过简短培训后，急诊医生（EP）可以安全地实施该操作。
在这项前瞻性、观察性、可行性研究中，对20例认知功能完整的孤立性髋部骨折患者进行了便利抽样，并实施了UFIB。在UFIB给药前和给药后的预定时间点记录8小时内的数字疼痛评分、生命体征和副作用。
所有患者在神经阻滞后疼痛均减轻，120分钟时平均疼痛评分降低了76%。没有出现操作并发症。
在这一小群急诊科患者中，UFIB提供了良好的镇痛效果且无并发症，可能是髋部骨折全身疼痛控制的有用辅助方法。
