Wennberg Pär, Norlin Rolf, Herlitz Johan, Sarenmalm Elisabeth Kenne, Möller Margareta
Research and Development Centre, Skaraborg Hospital, Skövde, Sweden; University Health Care Research Centre, Region Örebro, and School of Health Sciences, Örebro University, Sweden.
Capio Movement, Halmstad, Sweden; Department of Orthopedics, Örebro University Hospital, and Örebro University, Sweden.
Int J Orthop Trauma Nurs. 2019 May;33:35-43. doi: 10.1016/j.ijotn.2018.11.003. Epub 2018 Nov 28.
Pain management in patients with hip fractures is a major challenge for emergency care. The objective of this study was to evaluate whether the supplementation of pre-operative analgesia with low-dose fascia iliaca compartment block (FICB) compared with placebo would improve pain relief in patients with hip fractures.
A double-blind, randomized, controlled trial was conducted on 127 patients. At hospital admission, a low-dose FICB was administered to patients with hip fractures as a supplement to regular pre-operative analgesia. Patients with and without cognitive impairment were included. The instruments used were a visual analogue scale (VAS), a numerical rating scale and a tool for behavior related pain assessment. The primary endpoint was the change in reported pain on movement from hospital admission to two hours after FICB.
The intervention group showed improved pain management by mean VAS score for pain on movement compared with the control group (p = 0.002).
Our results support the use of low-dose FICB as a pain-relieving adjuvant to other analgesics when administered to patients with a hip fracture.
髋部骨折患者的疼痛管理是急诊护理面临的一项重大挑战。本研究的目的是评估与安慰剂相比，术前补充低剂量髂筋膜室阻滞（FICB）是否能改善髋部骨折患者的疼痛缓解情况。
对127例患者进行了一项双盲、随机、对照试验。入院时，对髋部骨折患者给予低剂量FICB，作为常规术前镇痛的补充。纳入了有认知障碍和无认知障碍的患者。使用的工具包括视觉模拟量表（VAS）、数字评定量表和行为相关疼痛评估工具。主要终点是从入院到FICB后两小时运动时报告的疼痛变化。
与对照组相比，干预组运动时疼痛的平均VAS评分显示疼痛管理得到改善（p = 0.002）。
我们的结果支持在对髋部骨折患者给药时，使用低剂量FICB作为其他镇痛药的止痛辅助剂。
