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Implementation of the Obturator Nerve Block into a Supra-Inguinal Fascia Iliaca Compartment Block Based Analgesia Protocol for Hip Arthroscopy: Retrospective Pre-Post Study

Background and Objectives: The effect of supra-inguinal fascia iliaca compartment block (SI-FICB) in hip arthroscopy is not apparent. It is also controversial whether SI-FICB can block the obturator nerve, which may affect postoperative analgesia after hip arthroscopy. We compared analgesic effects...

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Autores principales: Lee, Seounghun, Hwang, Jung-Mo, Lee, Sangmin, Eom, Hongsik, Oh, Chahyun, Chung, Woosuk, Ko, Young-Kwon, Lee, Wonhyung, Hong, Boohwi, Hwang, Deuk-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230392/
https://www.ncbi.nlm.nih.gov/pubmed/32230895
http://dx.doi.org/10.3390/medicina56040150
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author Lee, Seounghun
Hwang, Jung-Mo
Lee, Sangmin
Eom, Hongsik
Oh, Chahyun
Chung, Woosuk
Ko, Young-Kwon
Lee, Wonhyung
Hong, Boohwi
Hwang, Deuk-Soo
author_facet Lee, Seounghun
Hwang, Jung-Mo
Lee, Sangmin
Eom, Hongsik
Oh, Chahyun
Chung, Woosuk
Ko, Young-Kwon
Lee, Wonhyung
Hong, Boohwi
Hwang, Deuk-Soo
author_sort Lee, Seounghun
collection PubMed
description Background and Objectives: The effect of supra-inguinal fascia iliaca compartment block (SI-FICB) in hip arthroscopy is not apparent. It is also controversial whether SI-FICB can block the obturator nerve, which may affect postoperative analgesia after hip arthroscopy. We compared analgesic effects before and after the implementation of obturator nerve block into SI-FICB for hip arthroscopy. Materials and Methods: We retrospectively reviewed medical records of 90 consecutive patients who underwent hip arthroscopy from January 2017 to August 2019. Since August 2018, the analgesic protocol was changed from SI-FICB to SI-FICB with obturator nerve block. According to the analgesic regimen, patients were categorized as group N (no blockade), group F (SI-FICB only), and group FO (SI-FICB with obturator nerve block). Primary outcome was the cumulative opioid consumption at 24 hours after surgery. Additionally, cumulative opioid consumption at 6 and 12 hours after surgery, pain score, additional analgesic requests, intraoperative opioid consumption and hemodynamic stability, and postoperative nausea and vomiting were assessed. Results: Among 87 patients, there were 47 patients in group N, 21 in group F, and 19 in group FO. The cumulative opioid (fentanyl) consumption at 24 hours after surgery was significantly lower in the group FO compared with the group N (N: 678.5 (444.0–890.0) µg; FO: 482.8 (305.8–635.0) µg; p = 0.014), whereas the group F did not show a significant difference (F: 636.0 (426.8–803.0) µg). Conclusion: Our findings suggest that implementing obturator nerve block into SI-FICB can reduce postoperative opioid consumption in hip arthroscopy.
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spelling pubmed-72303922020-05-22 Implementation of the Obturator Nerve Block into a Supra-Inguinal Fascia Iliaca Compartment Block Based Analgesia Protocol for Hip Arthroscopy: Retrospective Pre-Post Study Lee, Seounghun Hwang, Jung-Mo Lee, Sangmin Eom, Hongsik Oh, Chahyun Chung, Woosuk Ko, Young-Kwon Lee, Wonhyung Hong, Boohwi Hwang, Deuk-Soo Medicina (Kaunas) Article Background and Objectives: The effect of supra-inguinal fascia iliaca compartment block (SI-FICB) in hip arthroscopy is not apparent. It is also controversial whether SI-FICB can block the obturator nerve, which may affect postoperative analgesia after hip arthroscopy. We compared analgesic effects before and after the implementation of obturator nerve block into SI-FICB for hip arthroscopy. Materials and Methods: We retrospectively reviewed medical records of 90 consecutive patients who underwent hip arthroscopy from January 2017 to August 2019. Since August 2018, the analgesic protocol was changed from SI-FICB to SI-FICB with obturator nerve block. According to the analgesic regimen, patients were categorized as group N (no blockade), group F (SI-FICB only), and group FO (SI-FICB with obturator nerve block). Primary outcome was the cumulative opioid consumption at 24 hours after surgery. Additionally, cumulative opioid consumption at 6 and 12 hours after surgery, pain score, additional analgesic requests, intraoperative opioid consumption and hemodynamic stability, and postoperative nausea and vomiting were assessed. Results: Among 87 patients, there were 47 patients in group N, 21 in group F, and 19 in group FO. The cumulative opioid (fentanyl) consumption at 24 hours after surgery was significantly lower in the group FO compared with the group N (N: 678.5 (444.0–890.0) µg; FO: 482.8 (305.8–635.0) µg; p = 0.014), whereas the group F did not show a significant difference (F: 636.0 (426.8–803.0) µg). Conclusion: Our findings suggest that implementing obturator nerve block into SI-FICB can reduce postoperative opioid consumption in hip arthroscopy. MDPI 2020-03-27 /pmc/articles/PMC7230392/ /pubmed/32230895 http://dx.doi.org/10.3390/medicina56040150 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Seounghun
Hwang, Jung-Mo
Lee, Sangmin
Eom, Hongsik
Oh, Chahyun
Chung, Woosuk
Ko, Young-Kwon
Lee, Wonhyung
Hong, Boohwi
Hwang, Deuk-Soo
Implementation of the Obturator Nerve Block into a Supra-Inguinal Fascia Iliaca Compartment Block Based Analgesia Protocol for Hip Arthroscopy: Retrospective Pre-Post Study
title Implementation of the Obturator Nerve Block into a Supra-Inguinal Fascia Iliaca Compartment Block Based Analgesia Protocol for Hip Arthroscopy: Retrospective Pre-Post Study
title_full Implementation of the Obturator Nerve Block into a Supra-Inguinal Fascia Iliaca Compartment Block Based Analgesia Protocol for Hip Arthroscopy: Retrospective Pre-Post Study
title_fullStr Implementation of the Obturator Nerve Block into a Supra-Inguinal Fascia Iliaca Compartment Block Based Analgesia Protocol for Hip Arthroscopy: Retrospective Pre-Post Study
title_full_unstemmed Implementation of the Obturator Nerve Block into a Supra-Inguinal Fascia Iliaca Compartment Block Based Analgesia Protocol for Hip Arthroscopy: Retrospective Pre-Post Study
title_short Implementation of the Obturator Nerve Block into a Supra-Inguinal Fascia Iliaca Compartment Block Based Analgesia Protocol for Hip Arthroscopy: Retrospective Pre-Post Study
title_sort implementation of the obturator nerve block into a supra-inguinal fascia iliaca compartment block based analgesia protocol for hip arthroscopy: retrospective pre-post study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230392/
https://www.ncbi.nlm.nih.gov/pubmed/32230895
http://dx.doi.org/10.3390/medicina56040150
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