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比较超髂筋膜间隙阻滞与连续硬膜外镇痛在髋关节手术患者中的应用:一项回顾性研究。

Comparison of the suprainguinal fascia iliaca compartment block with continuous epidural analgesia in patients undergoing hip surgeries: a retrospective study.

机构信息

Mersin Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Mersin, Turkey.

Mersin Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Mersin, Turkey.

出版信息

Braz J Anesthesiol. 2022 May-Jun;72(3):342-349. doi: 10.1016/j.bjane.2021.07.006. Epub 2021 Jul 26.

Abstract

BACKGROUND AND OBJECTIVE

Pain control is one of the major concerns after major hip surgeries. Suprainguinal fascia iliaca compartment block (S-FICB) is an alternative analgesic technique that can be considered as an effective and less invasive method than epidural analgesia (EA). In this retrospective study, we compared postoperative analgesic efficacy of single shot ultrasound guided S-FICB and EA after major hip surgery.

METHODS

We retrospectively examined 150 patients who underwent major hip surgeries and who received S-FICB or EA. Seventy-two patients submitted to EA and 78 patients who received S-FICB were included and their medical records retrospectively reviewed. Morphine consumptions, VAS scores, and side effects were recorded. Patients under antiplatelet or anticoagulant theraphy were also registered. Morphine consumption and VAS scores were the primary endpoints, succes rate and complications were the secondary endpoints of our study. P-values less than 0.05 were considered statistically significant.

RESULTS

Morphine consumption was lower at the emergence in the EA group but there was no statistically significant difference between the two groups according to total opioid consumption (0 [0-0] vs 0 [0-0]; p = 0.52). There was no difference between VAS scores in the first 18 hours. Hypotension was significantly higher in the EA group (9 vs 21; p = 0.04).

CONCLUSION

In conclusion, S-FICB can provide comparable analgesia with EA in the early postoperative period after hip surgery but VAS scores were found lower in the EA group than S-FICB group after 18 hour. Hypotension has occured more frequently in patients receiving EA.

摘要

背景与目的

髋部大手术后,疼痛控制是主要关注点之一。骼筋膜间隙阻滞(S-FICB)是一种替代的镇痛技术,与硬膜外镇痛(EA)相比,它是一种更有效、侵入性更小的方法。在这项回顾性研究中,我们比较了髋部大手术后单次超声引导下 S-FICB 和 EA 的术后镇痛效果。

方法

我们回顾性检查了 150 名接受髋部大手术并接受 S-FICB 或 EA 的患者。72 名患者接受 EA,78 名患者接受 S-FICB,回顾性审查他们的病历。记录吗啡消耗量、VAS 评分和副作用。还登记了正在接受抗血小板或抗凝治疗的患者。吗啡消耗量和 VAS 评分是本研究的主要终点,成功率和并发症是次要终点。p 值小于 0.05 被认为具有统计学意义。

结果

EA 组患者在苏醒时的吗啡消耗量较低,但两组患者的总阿片类药物消耗量无统计学差异(0 [0-0] 与 0 [0-0];p=0.52)。在最初 18 小时内,两组之间的 VAS 评分无差异。EA 组低血压发生率明显更高(9 例与 21 例;p=0.04)。

结论

总之,S-FICB 可在髋部手术后早期提供与 EA 相当的镇痛效果,但在 18 小时后,EA 组的 VAS 评分低于 S-FICB 组。接受 EA 的患者更常发生低血压。

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