Department of Anesthesiology & Perioperative Medicine, Penn State College of Medicine, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Curr Pain Headache Rep. 2021 Mar 11;25(4):22. doi: 10.1007/s11916-021-00940-9.
Over 300,000 patients are hospitalized annually following hip fractures in the USA. Many patients experienced inadequate analgesia. We will review the perioperative effects of the fascia iliaca compartment block (FICB) in hip fracture patients.
FICB by injecting local anesthetics beneath the fascia iliaca results in significant pain relief in hip fractures. Neuropathies and vascular injuries are almost unlikely. Single-shot FICB is faster to place, yet providing about 8 h of analgesia when bupivacaine is used. Continuous FICB provides prolonged titratable analgesia, improved patient satisfaction, and leads to faster hospital discharge. FICB reduces opioid consumption, decreases morbidity and mortality, reduces hospital stay, reduces delirium, and improves satisfaction. FICB should form part of a multimodal analgesic regime, in the context of a multidisciplinary approach to the management of hip fracture patients. More clinical investigations are needed to validate the long-term outcome benefits of FICB in hip fracture patients.
每年在美国有超过 30 万名髋部骨折患者住院治疗。许多患者经历了镇痛不足。我们将回顾髋部骨折患者的股前筋膜间室阻滞（FICB）的围手术期效果。
通过在股前筋膜下注射局部麻醉剂进行 FICB 可显著缓解髋部骨折患者的疼痛。神经损伤和血管损伤几乎不太可能发生。单次注射 FICB 放置速度更快，但当使用布比卡因时，可提供长达 8 小时的镇痛效果。连续 FICB 可提供可滴定的延长镇痛，提高患者满意度，并导致更快的出院。FICB 可减少阿片类药物的消耗，降低发病率和死亡率，缩短住院时间，减少谵妄，并提高满意度。FICB 应作为多模式镇痛方案的一部分，结合多学科方法管理髋部骨折患者。需要更多的临床研究来验证 FICB 在髋部骨折患者中的长期获益。
