Klukowski Mateusz, Kowalczyk Rafał, Górniewski Grzegorz, Łęgosz Paweł, Janiak Marek, Trzebicki Janusz
Warszawski Uniwersytet Medyczny I Klinika Anestezjologii i Intensywnej Terapii.
Warszawski Uniwersytet Medyczny Zakład Nauczania Anestezjologii i Intensywnej Terapii, Wydział Nauki o Zdrowiu.
Ortop Traumatol Rehabil. 2017 Oct 31;19(5):451-459. doi: 10.5604/01.3001.0010.5825.
Fractures of the proximal femur in elderly patients are a challenge for orthopedics, anesthe-sio-logy and geriatrics. Early mobilization reduces postoperative mortality among these patients. Effective anal-gesia is necessary to achieve this goal.
A retrospective analysis of perioperative medical records of 78. patients undergoing surgical treatment of proximal femur fractures was performed. Group 1 (n=35)consisted of patients who were treated with pharmacologic analgesia only (systemic analgesics) and Group 2 (n=43) involved patients who re-ceived a preoperative fascia iliaca compartment block (FICB) and pharmacologic analgesia. FICB was per-formed under ultrasound guidance, and systemic analgesics were administered according to a standardized pro-to-col. Demographics, anesthesia and operation data as well as the dosage of analgesics used on postoperative day 0 were collected for the study.
Patients with antecedent iliac fascia blockade required fewer analgesic interventions (3 vs. 11, p <0.0001) and showed significantly less need for analgesics than non-block patients. No complications were observed after performing FICB.
The iliac fascia compartment block produces effective postoperative analgesia and reduces postoperative opioid consumption.
老年患者股骨近端骨折对骨科、麻醉学和老年医学来说都是一项挑战。早期活动可降低这些患者的术后死亡率。实现这一目标需要有效的镇痛。
对78例接受股骨近端骨折手术治疗患者的围手术期病历进行回顾性分析。第1组（n = 35）仅采用药物镇痛（全身镇痛药）治疗，第2组（n = 43）包括接受术前髂筋膜间隙阻滞（FICB）和药物镇痛的患者。FICB在超声引导下进行，全身镇痛药根据标准化方案给药。收集研究对象的人口统计学、麻醉和手术数据以及术后第0天使用的镇痛药剂量。
先行髂筋膜阻滞的患者需要的镇痛干预较少（3次对11次，p < 0.0001），且与未阻滞患者相比，对镇痛药的需求明显更少。进行FICB后未观察到并发症。
髂筋膜间隙阻滞可产生有效的术后镇痛效果，并减少术后阿片类药物的消耗量。
