Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.
Department of Orthopedic Surgery, Chungnam National University, Daejeon, Korea.
Medicina (Kaunas). 2020 Mar 27;56(4):150. doi: 10.3390/medicina56040150.
The effect of supra-inguinal fascia iliaca compartment block (SI-FICB) in hip arthroscopy is not apparent. It is also controversial whether SI-FICB can block the obturator nerve, which may affect postoperative analgesia after hip arthroscopy. We compared analgesic effects before and after the implementation of obturator nerve block into SI-FICB for hip arthroscopy. We retrospectively reviewed medical records of 90 consecutive patients who underwent hip arthroscopy from January 2017 to August 2019. Since August 2018, the analgesic protocol was changed from SI-FICB to SI-FICB with obturator nerve block. According to the analgesic regimen, patients were categorized as group N (no blockade), group F (SI-FICB only), and group FO (SI-FICB with obturator nerve block). Primary outcome was the cumulative opioid consumption at 24 hours after surgery. Additionally, cumulative opioid consumption at 6 and 12 hours after surgery, pain score, additional analgesic requests, intraoperative opioid consumption and hemodynamic stability, and postoperative nausea and vomiting were assessed Among 87 patients, there were 47 patients in group N, 21 in group F, and 19 in group FO. The cumulative opioid (fentanyl) consumption at 24 hours after surgery was significantly lower in the group FO compared with the group N (N: 678.5 (444.0-890.0) µg; FO: 482.8 (305.8-635.0) µg; = 0.014), whereas the group F did not show a significant difference (F: 636.0 (426.8-803.0) µg). : Our findings suggest that implementing obturator nerve block into SI-FICB can reduce postoperative opioid consumption in hip arthroscopy.
股神经髂筋膜间隙阻滞（SI-FICB）在髋关节镜手术中的效果并不明显。SI-FICB 是否能阻滞闭孔神经也存在争议，这可能会影响髋关节镜手术后的术后镇痛。我们比较了实施闭孔神经阻滞入 SI-FICB 前后髋关节镜手术的镇痛效果。
我们回顾性分析了 2017 年 1 月至 2019 年 8 月期间连续 90 例接受髋关节镜手术的患者的病历。自 2018 年 8 月以来，镇痛方案从 SI-FICB 改为 SI-FICB 加闭孔神经阻滞。根据镇痛方案，患者分为 N 组（无阻滞）、F 组（仅 SI-FICB）和 FO 组（SI-FICB 加闭孔神经阻滞）。主要结局是术后 24 小时内的累积阿片类药物消耗量。此外，还评估了术后 6 小时和 12 小时的累积阿片类药物消耗量、疼痛评分、额外镇痛请求、术中阿片类药物用量和血流动力学稳定性以及术后恶心和呕吐。
在 87 例患者中，N 组 47 例，F 组 21 例，FO 组 19 例。与 N 组相比，FO 组术后 24 小时内累积阿片类药物（芬太尼）消耗量明显降低（N 组：678.5（444.0-890.0）µg；FO 组：482.8（305.8-635.0）µg；=0.014），而 F 组则无明显差异（F 组：636.0（426.8-803.0）µg）。
我们的研究结果表明，在 SI-FICB 中实施闭孔神经阻滞可以减少髋关节镜手术中的术后阿片类药物用量。
