BACKGROUND Fascia iliaca compartment blocks(FIBs) have been used to provide postoperative analgesia after total hip arthroplasty(THA). However, evidence of their efficacy remains limited. While pain control appears to...BACKGROUND Fascia iliaca compartment blocks(FIBs) have been used to provide postoperative analgesia after total hip arthroplasty(THA). However, evidence of their efficacy remains limited. While pain control appears to be satisfactory, quadriceps weakness may be an untoward consequence of the block. Prior studies have shown femoral nerve blocks and fascia iliaca blocks as being superior for pain control and ambulation following THA when compared to standard therapy of parenteral pain control. However, most studies allowed patients to ambulate on post-operative day(POD) 2-3, whereas new guidelines suggest ambulation on POD 0 is beneficial.AIM To determine the effect of FIB after THA in patients participating in an enhanced recovery after surgery(ERAS) program.METHODS We conducted a retrospective analysis of patients undergoing THA with or without FICBs and their ability to ambulate on POD 0 in accordance with ERAS protocol. Perioperative data was collected on 39 patients who underwent THA.Demographic data, anesthesia data, and ambulatory outcomes were compared.RESULTS Twenty patients had FIBs placed at the conclusion of the procedure, while 19 did not receive a block. Of the 20 patients with FIB, only 1 patient was able to ambulate. Of the 19 patients without FIB blocks, 17 were able to ambulate. All patients worked with physical therapy 2 h after arriving in the post-anesthesia care unit on POD 0.CONCLUSION Our data suggests an association between FIB and delayed ambulation in the immediate post-operative period.展开更多
The fascial vessels of skin flap in leg were studied systematically and quantitatively so as to find out the survival mechanism of fasciocutaneous flap and provide morphological basis for clinical application. Methods...The fascial vessels of skin flap in leg were studied systematically and quantitatively so as to find out the survival mechanism of fasciocutaneous flap and provide morphological basis for clinical application. Methods: Thirteen legs from adultcadavers were observed and measured by dissection under operating and biological microscopes, tissue clearing, slice and imageanalysis. Results: There were four types of source artery in fascia of leg and the intermuscular septal cutaneous artery was predominant and often anstomosed as a chain. The source arteries had supra- and subfascial branches in deep fascia and the former wasmore in number and larger in diameter. In the same way, the vascular network was thicker in the suprafascial level than in the subfascial. Aa% of the deep fascia was larger than that of the superficial fascia. Conclusion: The deep fascial vasculature is the basis of the blood supply of fasciocutaneous flap in leg and the suprafascial vascular network is especially important. It is suggestedthat the fascial pedicle should be selected wilers the arterial chain exists.展开更多
文摘BACKGROUND Fascia iliaca compartment blocks(FIBs) have been used to provide postoperative analgesia after total hip arthroplasty(THA). However, evidence of their efficacy remains limited. While pain control appears to be satisfactory, quadriceps weakness may be an untoward consequence of the block. Prior studies have shown femoral nerve blocks and fascia iliaca blocks as being superior for pain control and ambulation following THA when compared to standard therapy of parenteral pain control. However, most studies allowed patients to ambulate on post-operative day(POD) 2-3, whereas new guidelines suggest ambulation on POD 0 is beneficial.AIM To determine the effect of FIB after THA in patients participating in an enhanced recovery after surgery(ERAS) program.METHODS We conducted a retrospective analysis of patients undergoing THA with or without FICBs and their ability to ambulate on POD 0 in accordance with ERAS protocol. Perioperative data was collected on 39 patients who underwent THA.Demographic data, anesthesia data, and ambulatory outcomes were compared.RESULTS Twenty patients had FIBs placed at the conclusion of the procedure, while 19 did not receive a block. Of the 20 patients with FIB, only 1 patient was able to ambulate. Of the 19 patients without FIB blocks, 17 were able to ambulate. All patients worked with physical therapy 2 h after arriving in the post-anesthesia care unit on POD 0.CONCLUSION Our data suggests an association between FIB and delayed ambulation in the immediate post-operative period.
文摘The fascial vessels of skin flap in leg were studied systematically and quantitatively so as to find out the survival mechanism of fasciocutaneous flap and provide morphological basis for clinical application. Methods: Thirteen legs from adultcadavers were observed and measured by dissection under operating and biological microscopes, tissue clearing, slice and imageanalysis. Results: There were four types of source artery in fascia of leg and the intermuscular septal cutaneous artery was predominant and often anstomosed as a chain. The source arteries had supra- and subfascial branches in deep fascia and the former wasmore in number and larger in diameter. In the same way, the vascular network was thicker in the suprafascial level than in the subfascial. Aa% of the deep fascia was larger than that of the superficial fascia. Conclusion: The deep fascial vasculature is the basis of the blood supply of fasciocutaneous flap in leg and the suprafascial vascular network is especially important. It is suggestedthat the fascial pedicle should be selected wilers the arterial chain exists.
