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连续髂筋膜间隙阻滞对老年患者全髋关节置换术后早期恢复质量的影响:一项随机对照试验

Effects of Continuous Fascia Iliaca Compartment Block on Early Quality of Recovery After Total Hip Arthroplasty in Elderly Patients: A Randomized Controlled Trial.

作者信息

Gao Ying, Li He, Hu Hongfei, Xu Yi, Zhou Jun, Liu Youtan

机构信息

Department of Anesthesiology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518110, People's Republic of China.

Department of Anesthesiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People's Republic of China.

出版信息

J Pain Res. 2022 Jun 28;15:1837-1844. doi: 10.2147/JPR.S368285. eCollection 2022.

Abstract

PURPOSE

In recent years, patient-centered postoperative quality of recovery has gained attention. This study aimed to assess the influence of ultrasound-guided continuous fascia iliaca compartment block (CFICB) on early quality of recovery in elderly patients after total hip arthroplasty (THA) using the QoR-15 score.

PATIENTS AND METHODS

In this single-center, randomized, prospective study, 60 patients scheduled for unilateral THA were randomized to the CFICB or patient-controlled intravenous analgesia (PCIA) group. The primary outcome was the QoR-15 score. The secondary outcomes were pain score, number of patients requiring rescue analgesics, time of first postoperative ambulation, incidence of postoperative complications, Bromage score, and length of hospital stay.

RESULTS

The QoR-15 score was significantly higher in the CFICB group than in the PCIA group at 24 h (P < 0.001) after surgery. However, the QoR-15 score was not significantly different at 48 h (P = 0.074) between the two groups. Pain scores at rest and during movement were lower in the CFICB group than in the PCIA group at 12, 24, and 48 h postoperatively (P < 0.05). There was no difference in the number of patients requiring rescue analgesics, time of first postoperative ambulation, incidence of postoperative complications apart from dizziness, or length of hospital stay between the two groups. In addition, Bromage score of 1 point was reported by four patients in the CFICB group at 24 h (P = 0.048) after THA.

CONCLUSION

In elderly patients following THA, CFICB improved the quality of recovery at 24 h and reduced pain scores compared with PCIA. The time of first postoperative ambulation and length of hospital stay were not significantly affected.

摘要

目的

近年来,以患者为中心的术后恢复质量受到关注。本研究旨在使用QoR - 15评分评估超声引导下连续髂筋膜室阻滞(CFICB)对老年患者全髋关节置换术(THA)后早期恢复质量的影响。

患者与方法

在这项单中心、随机、前瞻性研究中,60例计划行单侧THA的患者被随机分为CFICB组或患者自控静脉镇痛(PCIA)组。主要结局指标为QoR - 15评分。次要结局指标包括疼痛评分、需要补救镇痛的患者数量、首次术后下床活动时间、术后并发症发生率、布罗麻评分及住院时间。

结果

术后24小时,CFICB组的QoR - 15评分显著高于PCIA组(P < 0.001)。然而,两组在48小时时QoR - 15评分无显著差异(P = 0.074)。术后12、24和48小时,CFICB组静息和活动时的疼痛评分均低于PCIA组(P < 0.05)。两组在需要补救镇痛的患者数量、首次术后下床活动时间、除头晕外的术后并发症发生率或住院时间方面无差异。此外,THA术后24小时,CFICB组有4例患者布罗麻评分为1分(P = 0.048)。

结论

在老年THA患者中,与PCIA相比,CFICB可改善术后24小时的恢复质量并降低疼痛评分。首次术后下床活动时间和住院时间未受到显著影响。

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