超声引导股外侧肌间隙阻滞在全髋关节置换术中的镇痛效果：系统评价和荟萃分析。

Ultrasound-guided fascia iliaca compartment block for pain control in total hip arthroplasty: A systematic review and meta-analysis.

机构信息

Department of Anaesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.

Department of Joint Surgery, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.

出版信息

Medicine (Baltimore). 2023 Nov 24;102(47):e36145. doi: 10.1097/MD.0000000000036145.

DOI:10.1097/MD.0000000000036145

PMID:38013302

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10681610/

Abstract

BACKGROUND

Previous studies have investigated the effectiveness and safety of ultrasound-guided fascia iliaca compartment block (UGFICB) compared to quadratus lumborum block (QLB) for pain management in total hip arthroplasty (THA). However, there is currently a lack of a systematic review specifically addressing this issue. Therefore, the purpose of this study was to conduct a comprehensive analysis and comparison of the efficacy and safety of UGFICB versus QLB for pain management in THA.

METHODS

An extensive search was conducted in various electronic databases, including PUBMED, EMBASE, Cochrane Library, Web of Science, Scopus, China Biomedical Literature Service System, and China National Knowledge Infrastructure. This search encompassed all relevant studies published from the inception of these databases until June 30, 2023. The selected outcomes for analysis included moving and resting visual analogue scale (VAS) scores at 12 hours and 24 hours post-surgery, as well as opioids consumption at 24 hours post-surgery. The Cochrane risk-of-bias tool was utilized to assess the risk of bias in the trials included in the analysis. Statistical analysis was conducted using RevMan 5.4 software.

RESULTS

A total of 8 trials, involving 656 patients, were included in this study. The results of the meta-analysis showed no significant differences between the 2 modalities in terms of moving VAS scores (mean difference [MD] = 0.17, 95% confidence interval [CI] [-0.79, 1.14], P = .72) and resting VAS scores (MD = 0.04, 95% CI [-0.27, 0.36], P = .78) at 12 hours post-surgery, and moving VAS scores (MD = 0.27, 95% CI [-0.46, 1.01], P = .47) and resting VAS scores (MD = -0.05, 95% CI [-0.45, 0.35], P = .80) at 24 hours post-surgery. However, there was significant differences in opioids consumption at 24 hours post-surgery (MD = 8.98, 95% CI [2.04, 15.93], P = .01) between the 2 groups.

CONCLUSION

Based on these findings, the study concludes that UGFICB may be more beneficial than QLB for pain management in THA. However, it is important to interpret these results with caution due to certain limitations.

摘要

背景

先前的研究已经调查了超声引导股外侧肌筋膜间隙阻滞（UGFICB）与竖脊肌阻滞（QLB）在全髋关节置换术（THA）中用于疼痛管理的有效性和安全性。然而，目前缺乏专门针对这一问题的系统评价。因此，本研究的目的是对 UGFICB 与 QLB 用于 THA 疼痛管理的疗效和安全性进行全面分析和比较。

方法

我们在各种电子数据库中进行了广泛的搜索，包括 PUBMED、EMBASE、Cochrane 图书馆、Web of Science、Scopus、中国生物医学文献服务系统和中国国家知识基础设施。该搜索涵盖了自这些数据库创建以来至 2023 年 6 月 30 日发表的所有相关研究。分析中选择的结果包括术后 12 小时和 24 小时的移动和休息视觉模拟量表（VAS）评分，以及术后 24 小时的阿片类药物消耗量。使用 Cochrane 偏倚风险工具评估纳入分析的试验的偏倚风险。使用 RevMan 5.4 软件进行统计分析。

结果

本研究共纳入 8 项试验，涉及 656 名患者。荟萃分析的结果显示，两种方法在术后 12 小时的移动 VAS 评分（均数差 [MD] = 0.17，95%置信区间 [CI] [-0.79, 1.14]，P =.72）和休息 VAS 评分（MD = 0.04，95%CI [-0.27, 0.36]，P =.78）以及术后 24 小时的移动 VAS 评分（MD = 0.27，95%CI [-0.46, 1.01]，P =.47）和休息 VAS 评分（MD = -0.05，95%CI [-0.45, 0.35]，P =.80）方面均无显著差异，但术后 24 小时阿片类药物消耗量存在显著差异（MD = 8.98，95%CI [2.04, 15.93]，P =.01）。