Yang Linyi, Li Min, Chen Chen, Shen Jiang, Bu Xiaoxuan
Department of Anesthesiology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
J Pain Res. 2017 Dec 14;10:2833-2841. doi: 10.2147/JPR.S149647. eCollection 2017.
The analgesic effect of fascia iliaca compartment block (FICB) versus no block (NB) after lower limb surgery (LLS) is still controversial, so we performed this meta-analysis.
By searching the PubMed, Embase and the Cochrane Library (last update by July 20, 2017), randomized controlled trials comparing the analgesic effect of FICB versus NB in patients receiving LLS were identified. The primary outcome was the pain scores at 4, 12, and 24 h after LLS. The dosage of morphine at 24 h was also collected. The side effect of anesthesia was assessed according to the occurrence rate of postoperative nausea and vomiting.
Data from 7 clinical trials that included 508 patients were summarized. The results showed that patients receiving FICB had lower pain scores at 4 h (mean difference [MD]=-1.17; 95% CI=-2.30 to -0.05; =0.041), 12 h (MD=-0.41; 95% CI=-0.76 to -0.05; =0.026) and 24 h (MD=-0.96; 95% CI=-1.77 to -0.15; =0.020) after LLS. Besides, FICB could reduce the dosage of morphine at 24 h (MD=-2.06; 95% CI=-3.82 to -0.30; =0.022) and the incidence of postoperative nausea and vomiting (relative risk rate=0.44, 95% CI=0.24-0.80, =0.008).
Compared with NB, FICB is an effective and safe method for alleviating the pain after LLS. More high-quality randomized controlled trials are needed to confirm this finding.
下肢手术（LLS）后，髂筋膜间隙阻滞（FICB）与不进行阻滞（NB）的镇痛效果仍存在争议，因此我们进行了这项荟萃分析。
通过检索PubMed、Embase和Cochrane图书馆（截至2017年7月20日的最新更新），确定了比较FICB与NB对接受LLS患者镇痛效果的随机对照试验。主要结局是LLS后4、12和24小时的疼痛评分。还收集了24小时吗啡用量。根据术后恶心呕吐发生率评估麻醉副作用。
总结了7项包含508例患者的临床试验数据。结果显示，接受FICB的患者在LLS后4小时（平均差[MD]= -1.17；95%可信区间[CI]= -2.30至-0.05；P = 0.041）、12小时（MD = -0.41；95% CI = -0.76至-0.05；P = 0.026）和24小时（MD = -0.96；95% CI = -1.77至-0.15；P = 0.020）的疼痛评分较低。此外，FICB可降低24小时吗啡用量（MD = -2.06；95% CI = -3.82至-0.30；P = 0.022）以及术后恶心呕吐发生率（相对危险率= 0.44，95% CI = 0.24 - 0.80，P = 0.008）。
与NB相比，FICB是缓解LLS后疼痛的一种有效且安全的方法。需要更多高质量的随机对照试验来证实这一发现。
