Department of Anesthesiology, The First Central Hospital of Baoding, Northern Great Wall Street 320#, Baoding, 071000, Hebei, China.
Department of Cardio-Thoracic Surgery, The First Central Hospital of Baoding, Baoding, 071000, China.
BMC Anesthesiol. 2023 Jun 8;23(1):197. doi: 10.1186/s12871-023-02162-5.
Iliopsoas plane block (IPB) is a novel analgesic technique for hip surgery that retains quadriceps strength. However, evidence from randomized controlled trial is remains unavailable. We hypothesized that IPB, as a motor-sparing analgesic technique, could match the femoral nerve block (FNB) in pain management and morphine consumption, providing an advantage for earlier functional training in patients underwent hip arthroplasty.
We recruited ninety patients with femoral neck fracture, femoral head necrosis or hip osteoarthritis who were scheduled for unilateral primary hip arthroplasty were recruited and received either IPB or FNB. Primary outcome was the pain score during hip flexion at 4 h after surgery. Secondary outcomes included quadriceps strength and pain scores upon arrival at post anesthesia care unit (PACU) and at 2, 4, 6, 24, 48 h after surgery, the first time out of bed, total opioids consumption, patient satisfaction, and complications.
There was no significant difference in terms of pain score during hip flexion at 4 h after surgery between the IPB group and FNB group. The quadriceps strength of patients receiving IPB was superior to those receiving FNB upon arrival at PACU and at 2, 4, 6 and 24 h after surgery. The IPB group showed a shorter first time out of bed compared to the FNB group. However, there were no significant differences in terms of pain scores within 48 h after surgery, total opioids consumption, patient satisfaction and complications between the two groups.
IPB was not superior to FNB in terms of postoperative analgesia for hip arthroplasty. However, IPB could serve as an effective motor-sparing analgesic technique for hip arthroplasty, which would facilitate early recovery and rehabilitation. This makes IPB worth considering as an alternative to FNB.
The trial was registered prior to patient enrollment at the Chinese Clinical Trial Registry (ChiCTR2200055493; registration date: January 10, 2022; enrollment date: January 18, 2022; https://www.chictr.org.cn/searchprojEN.html ).
腰大肌平面阻滞（IPB）是一种用于髋关节手术的新型镇痛技术，可保留股四头肌力量。然而，随机对照试验的证据仍然缺乏。我们假设 IPB 作为一种保留运动功能的镇痛技术，在疼痛管理和吗啡消耗方面可以与股神经阻滞（FNB）相匹配，为接受髋关节置换术的患者提供早期功能训练的优势。
我们招募了 90 名股骨颈骨折、股骨头坏死或髋骨关节炎患者，这些患者计划接受单侧初次髋关节置换术，并接受 IPB 或 FNB 治疗。主要结局是术后 4 小时髋关节屈曲时的疼痛评分。次要结局包括到达麻醉后护理单位（PACU）时和术后 2、4、6、24、48 小时时的股四头肌力量和疼痛评分、第一次下床时间、总阿片类药物消耗量、患者满意度和并发症。
在术后 4 小时髋关节屈曲时的疼痛评分方面，IPB 组和 FNB 组之间没有显著差异。到达 PACU 时和术后 2、4、6 和 24 小时时，接受 IPB 的患者的股四头肌力量优于接受 FNB 的患者。与 FNB 组相比，IPB 组的第一次下床时间更短。然而，两组在术后 48 小时内的疼痛评分、总阿片类药物消耗量、患者满意度和并发症方面没有显著差异。
在髋关节置换术后镇痛方面，IPB 并不优于 FNB。然而，IPB 可以作为髋关节置换术的一种有效保留运动功能的镇痛技术，有助于早期恢复和康复。这使得 IPB 作为 FNB 的替代方案值得考虑。
该试验在患者入组前在中国临床试验注册中心（ChiCTR2200055493；注册日期：2022 年 1 月 10 日；入组日期：2022 年 1 月 18 日；https://www.chictr.org.cn/searchprojEN.html）进行了注册。
