Abdelgalil Ahmed Salah, Ashour Hamed Sayed, Abdelrahman Ayman Sharawy, Ahmed Ahmed Fahmy, Mahmoud Fatma Hanafi, Sayed Hassan Mohamed El, El Samahy Khaled Ali, Abed Sayed Mahmoud
Pain Relief and Intensive Care Unit, National Cancer Institute, Cairo University, Cairo, Egypt.
Pain Rep. 2025 Aug 27;10(5):e1334. doi: 10.1097/PR9.0000000000001334. eCollection 2025 Oct.
Effective pain management is essential for patients undergoing limb-sparing procedures as well as amputation in patients with cancer.
This study evaluated the analgesic effects of the ultrasound-guided suprainguinal fascia iliaca block (SIFIB) and the ultrasound-guided lumbar erector spinae plane block (L-ESPB) in patients who underwent oncologic thigh surgery.
Seventy-five patients with thigh cancers and ASA class II, III were randomized into 3 groups: SIFIB, ESPB, and control groups. The primary outcome was opioid consumption within 24 hours. The secondary outcomes were intraoperative fentanyl consumption, time to first rescue analgesic request, pain scores, and patient satisfaction.
In our study, only 6 patients (24%) in the SIFIB group and 3 patients (12%) in the ESPB group required a single 3 mg dose of morphine, compared with 20 patients (80%) in the control group ( < 0.001). There was no significant difference between the SIFIB and ESPB groups in rescue morphine use ( = 0.463). Total fentanyl consumption was significantly lower in both the SIFIB and ESPB groups compared with the control group ( < 0.001), with no significant difference between the 2 blocks ( = 0.953). Time to first rescue analgesia was significantly longer in the SIFIB and ESPB groups compared with the control group ( < 0.001) and was similar between the block groups ( = 1.000). Pain scores were significantly lower and patient satisfaction significantly higher in both block groups compared with the control group ( = 0.042), with reduced postoperative nausea and vomiting.
In patients undergoing oncologic thigh surgery, SIFIB and L-ESPB are comparable, effective, and safe regional analgesic alternatives.
有效的疼痛管理对于接受保肢手术的患者以及癌症患者的截肢手术至关重要。
本研究评估了超声引导下腹股沟上髂筋膜阻滞（SIFIB）和超声引导下腰大肌平面阻滞（L-ESPB）在接受大腿肿瘤手术患者中的镇痛效果。
75例患有大腿癌症且ASA分级为II、III级的患者被随机分为3组：SIFIB组、ESPB组和对照组。主要结局是24小时内的阿片类药物消耗量。次要结局包括术中芬太尼消耗量、首次需要补救镇痛的时间、疼痛评分和患者满意度。
在我们的研究中，SIFIB组仅6例患者（24%）和ESPB组3例患者（12%）需要单次3mg剂量的吗啡，而对照组有20例患者（80%）需要（P<0.001）。SIFIB组和ESPB组在补救用吗啡使用方面无显著差异（P = 0.463）。与对照组相比，SIFIB组和ESPB组的芬太尼总消耗量均显著更低（P<0.001），两组间无显著差异（P = 0.953）。与对照组相比，SIFIB组和ESPB组首次补救镇痛的时间显著更长（P<0.001），两组间相似（P = 1.000）。与对照组相比，两组的疼痛评分均显著更低，患者满意度显著更高（P = 0.042），术后恶心和呕吐减少。
在接受大腿肿瘤手术的患者中，SIFIB和L-ESPB是相当、有效且安全的区域镇痛替代方法。
