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髋关节置换术后髂腰肌平面阻滞与股神经阻滞对术后恢复质量的影响:一项随机对照试验

Iliopsoas plane block versus femoral nerve block for postoperative quality of recovery following hip arthroplasty: a randomized controlled trial.

作者信息

Jiang Bo-Wei, Guo Ying, Han Ya-Nan, Bai Yan-Hui, Chen Xu, Zhao Ke-Fei, Liu Yi-Bo, Wang Chun-Guang

机构信息

Department of Anesthesiology, The First Central Hospital of Baoding, Northern Great wall Street 320#, Baoding, 071000, China.

Department of Dermatology, The Hospital of the People's Liberation Army Ground Force 82nd Group Army, Baoding, 071000, Hebei, China.

出版信息

Sci Rep. 2025 May 5;15(1):15723. doi: 10.1038/s41598-025-00978-4.

Abstract

The iliopsoas plane block (IPB) is a novel analgesic technique that has been demonstrated to be effective for hip fracture and hip replacement surgery. This study aimed to assess the effect of IPB on postoperative quality of recovery following elective hip arthroplasty compared with femoral nerve block (FNB). One hundred patients underwent elective hip arthroplasty were randomly assigned to the IPB or FNB groups. The primary outcome was the quality of recovery 24 h after surgery. Secondary outcomes included the quality of recovery at 48 and 72 h after surgery, pain scores, quadriceps strength, first time out of bed, total opioid consumption, patient satisfaction, and complications. Compared with participants in the FNB group, Quality of recovery-15 score at 24-h was significantly higher in the IPB group (127 [123-130] vs. 117.5 [113.7-120.2]), with a median difference of 9 (95% CI, 7-11; P < 0.001). Moreover, the QoR-15 score of the IPB group was higher than that of the FNB group at 48 and 72 h after surgery (P < 0.001). However, there were no clinically significant differences between the two groups. Quadriceps strength was superior in the IPB group than that in the FNB group (P < 0.001). The first time out of bed was shorter in the IPB group than that in the FNB group (P < 0.001). This study found that IPB enhanced the quality of recovery in the first 24 h following hip arthroplasty compared with FNB.Trial registration Chinese Clinical Trial Registry ChiCTR2200055289.

摘要

髂腰肌平面阻滞(IPB)是一种新型镇痛技术,已被证明对髋部骨折和髋关节置换手术有效。本研究旨在评估与股神经阻滞(FNB)相比,IPB对择期髋关节置换术后恢复质量的影响。100例行择期髋关节置换术的患者被随机分为IPB组或FNB组。主要结局是术后24小时的恢复质量。次要结局包括术后48小时和72小时的恢复质量、疼痛评分、股四头肌力量、首次下床时间、总阿片类药物消耗量、患者满意度和并发症。与FNB组参与者相比,IPB组术后24小时的恢复质量-15评分显著更高(127 [123-130] 对117.5 [113.7-120.2]),中位数差异为9(95%CI,7-11;P<0.001)。此外,术后48小时和72小时IPB组的QoR-15评分高于FNB组(P<0.001)。然而,两组之间无临床显著差异。IPB组的股四头肌力量优于FNB组(P<0.001)。IPB组的首次下床时间比FNB组短(P<0.001)。本研究发现,与FNB相比,IPB可提高髋关节置换术后最初24小时的恢复质量。试验注册:中国临床试验注册中心ChiCTR2200055289。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff7f/12053650/4f69f0ebc3f2/41598_2025_978_Fig1_HTML.jpg

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