Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly

Yu, Bin; He, Min; Cai, Guangyu; Zou, Tianxiao; Zhang, Na

doi:10.1097/md.0000000000005056

Cited by 38 publications

(37 citation statements)

References 17 publications

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“…The FICB has been used in several types of surgeries. Yu et al compared a continuous femoral nerve block and a continuous fascia iliaca compartment block in THA surgery for elder patients and found that the continuous fascia iliaca compartment block has a better effect on pain condition [23]. Williams et al revealed that standard analgesia combined with FICB significantly reduced the VAS scores of patients with femoral neck fractures after surgery [24].…”

Section: Discussionmentioning

confidence: 99%

Combination of post-fascia iliaca compartment block and dexmedetomidine in pain and inflammation control after total hip arthroplasty for elder patients: a randomized control study

Liu

et al. 2020

J Orthop Surg Res

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Objective: This study aims to investigate the efficiency of fascia iliaca compartment block (FICB) combined with dexmedetomidine (DEX) in postoperative and inflammation management for elder patients after total hip arthroplasty. Methods: The present randomized controlled study included a total of 119 elder patients who received total hip arthroplasty in our hospital from March 2016 to December 2018. These patients were divided into three groups: control group, patients received routine general anesthesia; FICB group, patients received additional FICB after surgery; and combined group, patients received both pre-treatment of DEX and post-treatment of fascia iliaca compartment block. The serum levels of interleukin (IL)-1β, IL-6, and C-reactive protein (CRP) were measured by ELISA. The visual analog scale (VAS) score was measured at 12, 24, 48, and 72 h after surgery, and the patientcontrolled intravenous analgesia (PCIA) pressing time within 48 h after surgery was also recorded. The Pittsburgh sleep quality index (PSQI) was used to measure the sleep quality before and at 1 month after surgery. Results: The VAS scores were significantly lower in patients in the combined group, when compared with the other two groups, at 12, 24, 48, and 72 h after surgery. In addition, the VAS scores at all time points were significantly lower in the FICB group than the control group. The PCIA pressing times were also remarkably lower in the combined group. At 4, 24, 48, and 72 h after surgery, the serum levels of these inflammatory factors were the lowest in the combined group, and the PSQI scores were significantly lower in the combined group, when compared with the other two groups, while the control group had the highest PSQI scores among the three groups. There was no severe side effects and significant difference observed. Conclusion: FICB combined with DEX reduced the postoperative pain, improved the sleep condition, and decreased the serum levels of inflammatory factors after total hip arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Combination of post-fascia iliaca compartment block and dexmedetomidine in pain and inflammation control after total hip arthroplasty for elder patients: a randomized control study

Liu

et al. 2020

J Orthop Surg Res

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“…17 Yu et al, compared continuous FICB and continuous FNB for postoperative pain relief in elderly patients who underwent hip replacement under general anaesthesia. 18 Postoperative VAS scores were comparable in both the groups.…”

Section: Discussionmentioning

confidence: 80%

USG guided femoral nerve block vs fascia iliaca compartment block as post-operative analgesia in hip fracture patients

Shukla¹,

Jahan²,

Naaz³

et al. 2018

Int J Res Med Sci

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Background: Adequate postoperative analgesia facilitates early mobilization which is important to reduce postoperative morbidity. Here, we intended to compare the efficacy of two different nerve blocks for postoperative pain relief in fractured neck of femur patients. Methods: One hundred and five patients posted either for dynamic hip screw or proximal femoral nail implantation under spinal anaesthesia were randomly allocated to three groups. At the end of surgery, group 1 received femoral nerve block (FNB) and group 2 received fascia iliaca compartment block (FICB) for postoperative pain relief. These blocks were ultrasound guided. Group 3 received no block and acted as control. Patients' pain was evaluated by Visual Analogue Scale (VAS) both at rest and at passive elevation of leg. Rescue analgesia was given when VAS score exceeded 3. Heart rate, mean arterial blood pressure, respiratory rate and total analgesic consumption in first 24 hours were also recorded. Results: Groups 1 and 2 had similar duration of analgesia of around 8 hours (P value = 0.727). Analgesic consumption in both these groups were similar (P value = 0.648). These groups had less pain, less analgesic requirement and more stable haemodynamics as compared to group 3. No adverse effect was seen due to application of block. Conclusions: FICB can be an effective alternative to femoral nerve block, because of its relative simplicity in technique and less invasiveness. Hence FICB holds considerable promise as an effective postoperative analgesia.

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“…Another study suggested that both ultrasound-guided continuous femoral nerve block and fascia iliaca compartment block with a novel cannula-over-needle provide effective anesthesia and postoperative analgesia for elderly patients with hip replacement (35). It has been reported that 3-in-1 femoral nerve block is also effective in hip fracture analgesia (20,36).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound‑guided continuous fascia iliaca compartment block for pre‑operative pain control in very elderly patients with hip fracture: A randomized controlled trial

Xue

et al. 2018

Exp Ther Med

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The present study presented the results of a prospective, randomized controlled trial. The present study enrolled 98 very elderly patients with hip fractures, complicated with at least one cardiovascular, neurological or pulmonary disease, of whom 10 patients were excluded. A total of 88 patients were randomly assigned into 2 groups: i) The control group, receiving traditional analgesia including 50 mg Tramadol and 500 mg paracetamol orally three times a day from admission to surgery; and ii) the study group, receiving ultrasound-guided continuous fascia iliaca compartment block (CFICB), a single 50 ml 0.4% ropivacaine injection with continuous infusion of 0.2% ropivacaine at a dose of 5 ml/h from admission to surgery. The primary outcome measure of pain relief or pain intensity was assessed preoperatively and up to 48 h postoperatively using a visual analog scale (VAS). The results of the present study indicated that in the preoperative period, in the morning of the day of surgery, the VAS pain at rest scores were lower in the study group compared with the control group (P=0.023). The VAS passive movement scores of the study group were also significantly lower compared with the control group 1 h following analgesia at the time of admission (P<0.05) and in the morning of the day of surgery (P<0.05). Scores for patients' satisfaction with the analgesic regimen in the preoperative period were greater in the study group compared with the control group (P<0.001). There was no difference in analgesia-associated side effects between groups. Duration of hospital stay of patients in the control group was significantly longer compared with the study group (P=0.001). Patients in the study group were less likely to have increased complications compared with patients in the control group over the N2-N4 period (from preoperative period to after surgery; P=0.016). The present study concluded that ultrasound guided CFICB was an effective method of providing analgesia for very elderly (≥80 years old) with hip fracture.

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Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly

Cited by 38 publications

References 17 publications

Combination of post-fascia iliaca compartment block and dexmedetomidine in pain and inflammation control after total hip arthroplasty for elder patients: a randomized control study

Combination of post-fascia iliaca compartment block and dexmedetomidine in pain and inflammation control after total hip arthroplasty for elder patients: a randomized control study

USG guided femoral nerve block vs fascia iliaca compartment block as post-operative analgesia in hip fracture patients

Ultrasound‑guided continuous fascia iliaca compartment block for pre‑operative pain control in very elderly patients with hip fracture: A randomized controlled trial

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