No abstract

No abstract

Low back pain (LBP) is a highly prevalent and burdensome health problem worldwide and the leading cause of disability in most countries. 1,2) Its high recurrence rate within 1 year after recovery from a previous episode is a key contributor to the recognition of LBP as the public health burden. [3][4][5] Smoking has been suggested as a risk factor for LBP. 6,7) However, evidence on the role of smoking in the development of LBP is inconsistent, [8][9][10] and the exact nature of that link has been largely untested in longterm cohort studies.In a recent meta-analysis 10) of 40 studies examining the relationship between smoking and LBP, current smokers had a 31% higher risk of LBP than nonsmokers, but that estimate applied only the preceding 12 months. None of the included studies were designed to determine wheth-

Introduction: The purpose of this study was to evaluate peripheral nerve block (PNB) effectiveness on postoperative pain management and surgical outcomes for displaced femoral-neck fracture in geriatric patients (>70 years) who underwent bipolar hemiarthroplasty (BHA). Methods: From January 2017 to December 2021, 231 geriatric patients with displaced femoral-neck fracture who consecutively underwent BHA were retrospectively reviewed. Patients were divided into two groups: patient-controlled analgesia (PCA) group (n=132) who received only intravenous (IV) PCA for postoperative pain management, and all others who received PNB with IV PCA (PNB+PCA) such as femoral nerve block or fascia iliaca compartment block after surgery (n=99). Primary outcomes were postoperative visual analog scale (VAS) at rest and during activity at 6, 24, and 48 hours postoperatively. Secondary outcomes were postoperative complications, changes in hemoglobin (Hb), length of hospital stay, and total morphine usage after surgery. Results: Postoperative resting VAS at 6 hours and 48 hours was significantly lower in the PNB+PCA group compared with the PCA group (p=0.075, p=0.0318, respectively). However, there was no significant difference in either resting VAS at 24 hours or active VAS. Complications of pneumonia and delirium until one month postoperative were significantly lower in the PNB + PCA group than the PCA group (p=0.0022, p=0.0055, respectively). Conclusion: PNB with IV PCA seems to have a beneficial effect on geriatric femoral-neck patients who underwent BHA with postoperative analgesia for reducing postoperative resting pain and complications, especially pneumonia and delirium.