髂筋膜间隙神经阻滞作为股骨骨折术后多模式镇痛一部分的疗效。
Efficacy of fascia iliaca compartment nerve block as part of multimodal analgesia after surgery for femoral bone fracture.
作者信息
Kumie Fentahun Tarekegn, Gebremedhn Endale Gebreegziabher, Tawuye Hailu Yimer
机构信息
Department of Anaesthesia, School of Medicine, Gondar College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
World J Emerg Med. 2015;6(2):142-6. doi: 10.5847/wjem.j.1920-8642.2015.02.010.
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 first 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 first analgesic request.
RESULTS
VAS pain scores were reduced within the first 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 first analgesic request was significantly 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 first 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.
背景
髂筋膜间隙神经阻滞（FICNB）一直是股骨骨折手术后用于术后镇痛的成熟技术。FICNB技术操作简单，对股骨骨折手术后的疼痛控制有效，且能减少全身镇痛药引起的并发症。全球范围内，术后疼痛的严重程度受遗传、文化和社会因素影响。在本研究中，我们评估了髂筋膜间隙神经阻滞作为股骨骨折手术后多模式镇痛一部分时的效果。
方法
2013年9月至2014年5月进行了一项基于机构的病例对照研究。纳入所有在蛛网膜下腔麻醉下接受股骨骨折手术的患者。患者分为FICNB组（n = 20）和对照组（n = 20）。FICNB组在手术结束时给予30 mL 0.25%布比卡因。在术后24小时内，即15分钟、2小时、6小时、12小时和24小时，使用100 mm视觉模拟评分法（VAS）评估术后疼痛、总镇痛药消耗量以及首次镇痛需求时间。
结果
与对照组相比，FICNB组术后24小时内VAS疼痛评分降低。2小时时VAS评分中位数（IQR）为0.00（0.00）vs. 18.00（30.00），P = 0.001；6小时时为0.00（0.00）vs. 34.00（20.75），P = 0.000；24小时时为12.50（10.00）vs. 31.50（20.75），P = 0.004；12小时时为（17.80±12.45）vs.（29.95±12.40），P = 0.004。FICNB组在12小时和24小时时双氯芬酸的总镇痛药消耗量减少，首次镇痛需求时间显著延长（417.50 vs. 139.25分钟，P = 0.000）。
结论
单次注射FICNB可使股骨骨折手术后FICNB组术后疼痛减轻、总镇痛药消耗量减少且首次镇痛需求时间延长。我们推荐FICNB用于股骨骨折手术后的镇痛以及急诊科股骨骨折患者。
Zotero 插件