Arsoy Diren, Gardner Michael J, Amanatullah Derek F, Huddleston James I, Goodman Stuart B, Maloney William J, Bishop Julius A
Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.
J Orthop Trauma. 2017 Jun;31(6):e186-e189. doi: 10.1097/BOT.0000000000000854.
To evaluate the effect of continuous femoral nerve catheter (CFNC) for postoperative pain control in geriatric proximal femur fractures compared with standard analgesia (SA) treatment.
Retrospective comparative study.
Academic Level 1 trauma center.
PATIENTS/PARTICIPANTS: We retrospectively identified 265 consecutive geriatric hip fracture patients who underwent surgical treatment.
One hundred forty-nine patients were treated with standard analgesia without nerve catheter whereas 116 patients received an indwelling CFNC.
Daily average preoperative and postoperative pain scores, daily morphine equivalent consumption, opioid-related side effects and discharge disposition.
Patients with CFNC patients reported lower average pain scores preoperatively (1.9 ± 1.7 for CFNC vs. 4.7 ± 2 for SA; P < 0.0001), on postoperative day 1 (1.5 ± 1.6 for CFNC vs. 3 ± 1.7 for SA; P < 0.0001) and postoperative day 2 (1.2 ± 1.5 for CFNC vs. 2.6 ± 2.1 for SA; P < 0.0001). CFNC group consumed 39% less morphine equivalents on postoperative day 1 (4.4 ± 5.8 mg for CFNC vs. 7.2 ± 10.8 mg for SA; P = 0.005) and 50% less morphine equivalent on postoperative day 2 (3.4 ± 4.4 mg for CFNC vs. 6.8 ± 13 mg for SA; P = 0.105). Patients with CFNC had a lower rate of opioid-related side effects compared with patients with SA (27.5% for CFNC vs. 47% for SA; P = 0.001). More patients with CFNC were discharged to home with or without health services than patients with SA (15% for CFNC vs. 6% for SA; P = 0.023).
Continuous femoral nerve catheter decreased daily average patient-reported pain scores, narcotic consumption while decreasing the rate of opioid-related side effects. Patients with CFNC were discharged to home more frequently.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
评估与标准镇痛（SA）治疗相比，连续股神经导管（CFNC）用于老年股骨近端骨折术后疼痛控制的效果。
回顾性比较研究。
一级学术创伤中心。
患者/参与者：我们回顾性确定了265例连续接受手术治疗的老年髋部骨折患者。
149例患者接受无神经导管的标准镇痛治疗，而116例患者接受留置CFNC治疗。
术前和术后每日平均疼痛评分、每日吗啡当量消耗量、阿片类药物相关副作用及出院处置情况。
CFNC组患者术前平均疼痛评分较低（CFNC组为1.9±1.7，SA组为4.7±2；P<0.0001），术后第1天（CFNC组为1.5±1.6，SA组为3±1.7；P<0.0001）和术后第2天（CFNC组为1.2±1.5，SA组为2.6±2.1；P<0.0001）。CFNC组术后第1天吗啡当量消耗量减少39%（CFNC组为4.4±5.8mg，SA组为7.2±10.8mg；P=0.005），术后第2天吗啡当量消耗量减少50%（CFNC组为3.4±4.4mg，SA组为6.8±13mg；P=0.105）。与SA组患者相比，CFNC组患者阿片类药物相关副作用发生率较低（CFNC组为27.5%，SA组为47%；P=0.001）。与SA组患者相比，更多接受CFNC治疗的患者在有或无医疗服务的情况下出院回家（CFNC组为15%，SA组为6%；P=0.023）。
连续股神经导管降低了患者报告的每日平均疼痛评分、麻醉药物消耗量，同时降低了阿片类药物相关副作用的发生率。接受CFNC治疗的患者更频繁地出院回家。
治疗性III级。有关证据水平的完整描述，请参阅《作者须知》。
