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Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block

BACKGROUND: Fascia iliaca compartment block (FICB) is an anterior approach to the lumbar plexus block and provides the effective adjunctive analgesia for total hip arthroplasty (THA). METHODS: As a case series study, 28 patients (≥ 65 years old) with THA were received a modified in-plane ultrasound-...

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Autores principales: Zheng, Ting, Hu, Bin, Zheng, Chun-ying, Huang, Feng-yi, Gao, Fei, Zheng, Xiao-chun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944595/
https://www.ncbi.nlm.nih.gov/pubmed/33691623
http://dx.doi.org/10.1186/s12871-021-01296-8
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author Zheng, Ting
Hu, Bin
Zheng, Chun-ying
Huang, Feng-yi
Gao, Fei
Zheng, Xiao-chun
author_facet Zheng, Ting
Hu, Bin
Zheng, Chun-ying
Huang, Feng-yi
Gao, Fei
Zheng, Xiao-chun
author_sort Zheng, Ting
collection PubMed
description BACKGROUND: Fascia iliaca compartment block (FICB) is an anterior approach to the lumbar plexus block and provides the effective adjunctive analgesia for total hip arthroplasty (THA). METHODS: As a case series study, 28 patients (≥ 65 years old) with THA were received a modified in-plane ultrasound-guided supra-inguinal (S-FICB) as an analgesic adjunct to evaluate the analgesic effectiveness and the local anesthetic diffusion with magnetic resonance imaging (MRI). A combination of propofol and sufentanil was administered to conduct target-controlled infusion. RESULTS: The pain scores were 1 (0–4), 2 (1–5), 3 (1–6) and 3 (1–6) at 4, 8, 12, and 24 h. The cumulative opioids were 8 (8–12), 18 (16–32), 28 (24–54) and 66 (48–104) mg of i.v. morphine equivalents at 4, 8, 12, and 24 h. The patient-controlled analgesia (PCA) times were 0 (0–1), 1 (0–2), 2 (0–5) and 5 (3–8) at 4, 8, 12, and 24 h. In lateral, anterior and medial part of thigh, the sensory blockade in 28 patients was 23 (82 %), 21 (75 %) and 19 (68 %) at 5 min; 28 (100 %) at 10 and 20 min. Motor blockade of femoral nerve (FN) and obturator nerve (ON) was present in 13 (46 %) and 3 (11 %) patients at 5 min, 24 (86 %) and 9 (32 %) at 10 min, 26 (93 %) and 11 (39 %) at 20 min. Injectate permeated to the FN and extended superiorly over the surface of iliac muscle (IM) and pectineus muscle (PM) in all patients. CONCLUSIONS: The modified S-FICB has provided an effective postoperative analgesic adjunct after THA with the satisfactory blockade of femoral (FN), obturator (ON) and sciatic (SN) nerves, especially for ON, when compared with the existing techniques.
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spelling pubmed-79445952021-03-10 Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block Zheng, Ting Hu, Bin Zheng, Chun-ying Huang, Feng-yi Gao, Fei Zheng, Xiao-chun BMC Anesthesiol Research Article BACKGROUND: Fascia iliaca compartment block (FICB) is an anterior approach to the lumbar plexus block and provides the effective adjunctive analgesia for total hip arthroplasty (THA). METHODS: As a case series study, 28 patients (≥ 65 years old) with THA were received a modified in-plane ultrasound-guided supra-inguinal (S-FICB) as an analgesic adjunct to evaluate the analgesic effectiveness and the local anesthetic diffusion with magnetic resonance imaging (MRI). A combination of propofol and sufentanil was administered to conduct target-controlled infusion. RESULTS: The pain scores were 1 (0–4), 2 (1–5), 3 (1–6) and 3 (1–6) at 4, 8, 12, and 24 h. The cumulative opioids were 8 (8–12), 18 (16–32), 28 (24–54) and 66 (48–104) mg of i.v. morphine equivalents at 4, 8, 12, and 24 h. The patient-controlled analgesia (PCA) times were 0 (0–1), 1 (0–2), 2 (0–5) and 5 (3–8) at 4, 8, 12, and 24 h. In lateral, anterior and medial part of thigh, the sensory blockade in 28 patients was 23 (82 %), 21 (75 %) and 19 (68 %) at 5 min; 28 (100 %) at 10 and 20 min. Motor blockade of femoral nerve (FN) and obturator nerve (ON) was present in 13 (46 %) and 3 (11 %) patients at 5 min, 24 (86 %) and 9 (32 %) at 10 min, 26 (93 %) and 11 (39 %) at 20 min. Injectate permeated to the FN and extended superiorly over the surface of iliac muscle (IM) and pectineus muscle (PM) in all patients. CONCLUSIONS: The modified S-FICB has provided an effective postoperative analgesic adjunct after THA with the satisfactory blockade of femoral (FN), obturator (ON) and sciatic (SN) nerves, especially for ON, when compared with the existing techniques. BioMed Central 2021-03-10 /pmc/articles/PMC7944595/ /pubmed/33691623 http://dx.doi.org/10.1186/s12871-021-01296-8 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Zheng, Ting
Hu, Bin
Zheng, Chun-ying
Huang, Feng-yi
Gao, Fei
Zheng, Xiao-chun
Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block
title Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block
title_full Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block
title_fullStr Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block
title_full_unstemmed Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block
title_short Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block
title_sort improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944595/
https://www.ncbi.nlm.nih.gov/pubmed/33691623
http://dx.doi.org/10.1186/s12871-021-01296-8
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