anesthesiology department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
BMC Anesthesiol. 2023 Mar 29;23(1):98. doi: 10.1186/s12871-023-02049-5.
Hip arthroplasty is effective in treating hip diseases, such as osteoarthritis and hip fracture, but it often brings severe trauma and pain. In recent years, ultrasound-guided supra-inguinal fascia iliaca compartment block(S-FICB) has become a widely used nerve block method for analgesia in hip arthroplasty.
Fifty-three patients preparing for hip arthroplasty were prospectively enrolled. S-FICB was performed under ultrasound guidance, and inject 0.33% ropivacaine into the space. Using the biased-coin design (BCD) sequential allocation method. The initial volume of 0.33% ropivacaine was 30ml. In case of failure, the next patient received a higher volume (defined as the previous volume with an increment of 1.2 mL). If the previous patient had a successful block, the next patient was randomized to a lower volume (defined as the previous volume with a decrement of 1.2 mL), with a probability of b = 0.05, or the same volume, with a probability of 1 - b = 0.95. The study was stopped when 45 successful blocks were achieved.
Forty-five patients (84.9%) were blocked successfully. The 95% effective volume (EV95) was 34.06ml (95%CI 33.35 ~ 36.28ml). There were 31 patients with non-fracture in this study. The quadriceps muscle strength decreased in only two patients. Moreover, they both received 34.8ml of ropivacaine for S-FICB. Twenty-two patients had hip fractures. There were 3 patients (14%) with failed blocks and 19 patients (86%) with successful blocks. However, all fracture patients experienced less pain after S-FICB.
EV95 of 0.33% ropivacaine for ultrasound-guided S-FICB was 34.06ml.
The trial was registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2100052214, registration date: 2021 October 22).
髋关节置换术在治疗髋关节疾病，如骨关节炎和髋部骨折等方面非常有效，但它通常会带来严重的创伤和疼痛。近年来，超声引导下骼筋膜间隙阻滞（S-FICB）已成为髋关节置换术镇痛的一种广泛应用的神经阻滞方法。
前瞻性纳入 53 例准备行髋关节置换术的患者。在超声引导下进行 S-FICB，向间隙内注射 0.33%罗哌卡因。采用偏倚硬币设计（BCD）序贯分配方法。0.33%罗哌卡因的初始容量为 30ml。如果阻滞失败，下一位患者接受更高的容量（定义为前一容量增加 1.2ml）。如果前一位患者阻滞成功，下一位患者随机接受较低的容量（定义为前一容量减少 1.2ml），b 值为 0.05，或相同的容量，1-b 值为 0.95。当 45 例成功阻滞时，研究停止。
45 例（84.9%）患者阻滞成功。95%有效容量（EV95）为 34.06ml（95%CI 33.35~36.28ml）。本研究中有 31 例患者无骨折。只有 2 例患者股四头肌力量减弱。而且，他们都接受了 34.8ml 的罗哌卡因进行 S-FICB。22 例患者髋部骨折。有 3 例（14%）患者阻滞失败，19 例（86%）患者阻滞成功。然而，所有骨折患者在 S-FICB 后疼痛均减轻。
超声引导下 S-FICB 中 0.33%罗哌卡因的 EV95 为 34.06ml。
该试验在中国临床试验注册中心注册（注册号：ChiCTR2100052214，注册日期：2021 年 10 月 22 日）。
