School of Medicine, University of Dundee, Dundee DD1 4HN, UK.
School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK.
Pain Res Manag. 2024 Jun 19;2024:4518587. doi: 10.1155/2024/4518587. eCollection 2024.
Hip arthroplasty is a common procedure with high costs and difficult rehabilitation. It causes postoperative pain, and this can reduce mobility which extends in-patient time. An optimal analgesia regime is crucial to identify. Opioids produce effective pain relief but are associated with nausea, vomiting, and respiratory depression which can hinder physiotherapy and discharge. Finding alternatives has been of interest in recent years, particularly fascial blocks. These are anaesthetic injections beneath fascia which spread to nerves providing pain relief from surgery and are used with a general or spinal anaesthetic. Two of these blocks which are of interest to total hip arthroplasty are the quadratus lumborum block and fascia iliaca block. Studies have investigated the effectiveness of these blocks through patient factors, primarily pain scores, opioid consumption, and other secondary outcomes such as ambulation and length of stay. This review takes a narrative approach and investigates the literature around the topic. Pain and opioid consumption were the most widely reported outcomes, reported in 90% and 86% of studies. 83% of these studies reported positive effects on pain scores when FIB was utilised. 80% of these studies reported positive effects on opioid consumption when FIB was used. When QLB block was utilised, pain and opioid consumption were positively impacted in 82% of studies. This paper has been written with the intention of reviewing current literature to give an impression of the effectiveness of the blocks and propose potential areas for future work on the blocks.
髋关节置换术是一种常见的手术，费用高昂，康复困难。它会导致术后疼痛，这会降低活动能力，延长住院时间。因此，确定一个最佳的镇痛方案至关重要。阿片类药物可以有效缓解疼痛，但会引起恶心、呕吐和呼吸抑制，从而阻碍物理治疗和出院。近年来，人们一直在寻找替代方案，特别是筋膜阻滞。这些是在筋膜下注射麻醉剂，扩散到神经，从而缓解手术引起的疼痛，并与全身麻醉或脊髓麻醉一起使用。两种对全髋关节置换术有兴趣的筋膜阻滞是竖脊肌筋膜阻滞和髂筋膜阻滞。研究通过患者因素，主要是疼痛评分、阿片类药物消耗和其他次要结果，如活动能力和住院时间，来研究这些阻滞的有效性。本综述采用叙述性方法调查该主题的文献。疼痛和阿片类药物消耗是报告最多的结果，90%和 86%的研究报告了这两个结果。83%的研究报告称，当使用 FIB 时，对疼痛评分有积极影响。80%的研究报告称，当使用 FIB 时，对阿片类药物消耗有积极影响。当使用 QLB 阻滞时，82%的研究报告称疼痛和阿片类药物消耗有积极影响。本文旨在综述当前的文献，以了解这些阻滞的有效性，并提出未来对这些阻滞的潜在研究方向。
