BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pa...BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.展开更多
BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique tha...BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique that is easy to implement.Here,we report a case of fascia iliaca compartment block in a patient with myocardial infarction who underwent emergency middle thigh amputation.CASE SUMMARY A 78-year-old female patient weighing 38 kg with gangrene and occlusive peripheral atherosclerosis of the right leg underwent an emergency middle thigh amputation.The patient had a history of hypertension,coronary heart disease,cerebral infarction,anterior wall myocardial infarction,and had recently undergone percutaneous coronary intervention consisting of coronary angiography and right coronary artery stent implantation.Considering the patient's condition,an ultrasound-guided fascia iliaca compartment block combined with general anesthesia was implemented for amputation.The fascia iliaca compartment block provided analgesia for the operation,and reduced the dosage of general anesthetics.It also alleviated adverse cardiovascular effects caused by pain stress,and ensured the safety of the patient during the perioperative period.This block also provided postoperative analgesia.The patient had a good prognosis,and was subsequently discharged from hospital.CONCLUSION Fascia iliaca compartment block provides surgical analgesia.It also alleviates adverse cardiovascular effects,and ensures patient safety during the perioperative period.展开更多
BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.CASE SUMMARY Th...BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.CASE SUMMARY This report established that hip surgical procedures can be performed with a fascia iliaca compartment block(FICB)and monitored anesthesia care(MAC)while avoiding neuraxial or general anesthesia.This was a preliminary experience with two geriatric patients with hip fracture,American Society of Anesthesiologists status III,and with many comorbidities.Neither patient could be operated on within 48 h after admission.Both general anesthesia and neuraxial anesthesia were high-risk procedures and had contraindications.Hence,we chose nerve block combined with a small amount of sedation.Intraoperative analgesia was provided by single-injection ultrasound-guided FICB.Light intravenous sedation was added.Surgical exposure was satisfactory,and neither patient complained of any symptoms during the procedure.CONCLUSION This report showed that hip surgery for geriatric patients can be performed with FICB and MAC,although complications and contraindications are common.The anesthetic program was accompanied by stable respiratory and circulatory system responses and satisfactory analgesia while avoiding the adverse effects and problems associated with either neuraxial or general anesthesia.展开更多
Objective:To investigate the effect of fascia iliaca compartment block combined with general anesthesia on the pain and inflammatory stress mediator secretion after hip replacement. Methods: A total of 170 patients wi...Objective:To investigate the effect of fascia iliaca compartment block combined with general anesthesia on the pain and inflammatory stress mediator secretion after hip replacement. Methods: A total of 170 patients with femoral neck fracture who underwent hip replacement in this hospital between September 2015 and August 2017 were divided into the control group (n=103) who underwent routine general anesthesia and the study group (n=67) who underwent fascia iliaca compartment block combined with general anesthesia after the anesthetic solutions were reviewed. The differences in serum contents of pain mediators, inflammatory factors and stress hormones were compared between the two groups of patients immediately after surgery as well as 12 h and 24 h after surgery.Results: Immediately after surgery, there was no statistically significant difference in serum contents of pain mediators, inflammatory factors and stress hormones between the two groups. 12 h and 24 h after surgery, serum pain mediators NPY, PGE2, 5-HT,β-EP and SP contents of study group were lower than those of control group;serum inflammatory factors CRP, TNF-α and IL-1β contents were lower than those of control group;serum stress hormones Cor, CA and ACTH contents were lower than those of control group.Conclusion: fascia iliaca compartment block combined with general anesthesia can effectively reduce the postoperative pain as well as the systemic inflammatory response and stress response induced by pain in patients with hip replacement.展开更多
Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly ...Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly patients who received hip replacement in Mianyang Central Hospital between December 2015 and June 2017 were selected and randomly divided into multimodal analgesia group (MMA group), and patient-controlled intravenous analgesia group (PCIA group), MMA received ropivacaine fascia iliaca compartment block, dezocine preemptive analgesia combined with patient-controlled intravenous analgesia, and PCAI group received patient-controlled intravenous analgesia. The levels of pain-related molecules and stress-related hormones in serum as well as the levels of stress-related immune molecules in peripheral blood were detected immediately after surgery and 12 h after surgery. Results: 12 h after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of both groups of patients were significantly higher than those immediately after surgery, peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly lower than those immediately after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of MMA group 12 h after surgery were significantly lower than those of PCIA group, and peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly higher than those of PCIA group. Conclusion: Ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia can reduce the pain and stress response after hip replacement.展开更多
目的评价超声引导下右美托咪定混合罗哌卡因髂筋膜间隙阻滞(FICB)对小儿髋部手术的镇痛效果。方法选取2014年1月至2015年6月在佛山市中医院择期行单侧发育性髋脱位手术的患儿60例,采用随机数字表法,将患者分为两组(各30例)。观察组气管...目的评价超声引导下右美托咪定混合罗哌卡因髂筋膜间隙阻滞(FICB)对小儿髋部手术的镇痛效果。方法选取2014年1月至2015年6月在佛山市中医院择期行单侧发育性髋脱位手术的患儿60例,采用随机数字表法,将患者分为两组(各30例)。观察组气管插管全麻复合超声引导下1μg/kg右美托咪定混合0.2%罗哌卡因1mL/kg FICB,对照组单用气管插管全麻,两组术后均行芬太尼静脉自控镇痛(PCIA)。分别记录术中芬太尼用量,及术后1、2、4、8、12、24、48h的患儿哭泣、呼吸、循环、表情和睡眠疼痛行为学评分,PCIA按压次数,记录不良反应发生情况。结果与对照组比较,观察组术中芬太尼用量显著减少(49.68±15.29μg vs 68.55±20.03μg,t=4.102,P<0.05),术后各时点CRIES疼痛行为学评分(t=3.644~21.610)及PCIA按压次数(t=3.260~31.770)显著低于对照组(均P<0.05),两组均未见有呼吸抑制。观察组恶心呕吐发生2例(6.67%),对照组恶心呕吐发生6例(20.00%)(x~=2.308,P=0.129);观察组瘙痒发生1例(3.33%),对照组瘙痒发生4例(13.33%)(x^2=1.964,P=0.161)。结论超声引导下1μg/kg右美托咪定混合0.2%罗哌卡因1mL/kg FICB可有效缓解小儿发育性髋脱位(DDH)手术患者疼痛,且无明显不良反应,镇痛效果确切持久,实施方法简便易行。展开更多
文摘BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.
文摘BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique that is easy to implement.Here,we report a case of fascia iliaca compartment block in a patient with myocardial infarction who underwent emergency middle thigh amputation.CASE SUMMARY A 78-year-old female patient weighing 38 kg with gangrene and occlusive peripheral atherosclerosis of the right leg underwent an emergency middle thigh amputation.The patient had a history of hypertension,coronary heart disease,cerebral infarction,anterior wall myocardial infarction,and had recently undergone percutaneous coronary intervention consisting of coronary angiography and right coronary artery stent implantation.Considering the patient's condition,an ultrasound-guided fascia iliaca compartment block combined with general anesthesia was implemented for amputation.The fascia iliaca compartment block provided analgesia for the operation,and reduced the dosage of general anesthetics.It also alleviated adverse cardiovascular effects caused by pain stress,and ensured the safety of the patient during the perioperative period.This block also provided postoperative analgesia.The patient had a good prognosis,and was subsequently discharged from hospital.CONCLUSION Fascia iliaca compartment block provides surgical analgesia.It also alleviates adverse cardiovascular effects,and ensures patient safety during the perioperative period.
文摘BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.CASE SUMMARY This report established that hip surgical procedures can be performed with a fascia iliaca compartment block(FICB)and monitored anesthesia care(MAC)while avoiding neuraxial or general anesthesia.This was a preliminary experience with two geriatric patients with hip fracture,American Society of Anesthesiologists status III,and with many comorbidities.Neither patient could be operated on within 48 h after admission.Both general anesthesia and neuraxial anesthesia were high-risk procedures and had contraindications.Hence,we chose nerve block combined with a small amount of sedation.Intraoperative analgesia was provided by single-injection ultrasound-guided FICB.Light intravenous sedation was added.Surgical exposure was satisfactory,and neither patient complained of any symptoms during the procedure.CONCLUSION This report showed that hip surgery for geriatric patients can be performed with FICB and MAC,although complications and contraindications are common.The anesthetic program was accompanied by stable respiratory and circulatory system responses and satisfactory analgesia while avoiding the adverse effects and problems associated with either neuraxial or general anesthesia.
文摘Objective:To investigate the effect of fascia iliaca compartment block combined with general anesthesia on the pain and inflammatory stress mediator secretion after hip replacement. Methods: A total of 170 patients with femoral neck fracture who underwent hip replacement in this hospital between September 2015 and August 2017 were divided into the control group (n=103) who underwent routine general anesthesia and the study group (n=67) who underwent fascia iliaca compartment block combined with general anesthesia after the anesthetic solutions were reviewed. The differences in serum contents of pain mediators, inflammatory factors and stress hormones were compared between the two groups of patients immediately after surgery as well as 12 h and 24 h after surgery.Results: Immediately after surgery, there was no statistically significant difference in serum contents of pain mediators, inflammatory factors and stress hormones between the two groups. 12 h and 24 h after surgery, serum pain mediators NPY, PGE2, 5-HT,β-EP and SP contents of study group were lower than those of control group;serum inflammatory factors CRP, TNF-α and IL-1β contents were lower than those of control group;serum stress hormones Cor, CA and ACTH contents were lower than those of control group.Conclusion: fascia iliaca compartment block combined with general anesthesia can effectively reduce the postoperative pain as well as the systemic inflammatory response and stress response induced by pain in patients with hip replacement.
文摘Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly patients who received hip replacement in Mianyang Central Hospital between December 2015 and June 2017 were selected and randomly divided into multimodal analgesia group (MMA group), and patient-controlled intravenous analgesia group (PCIA group), MMA received ropivacaine fascia iliaca compartment block, dezocine preemptive analgesia combined with patient-controlled intravenous analgesia, and PCAI group received patient-controlled intravenous analgesia. The levels of pain-related molecules and stress-related hormones in serum as well as the levels of stress-related immune molecules in peripheral blood were detected immediately after surgery and 12 h after surgery. Results: 12 h after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of both groups of patients were significantly higher than those immediately after surgery, peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly lower than those immediately after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of MMA group 12 h after surgery were significantly lower than those of PCIA group, and peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly higher than those of PCIA group. Conclusion: Ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia can reduce the pain and stress response after hip replacement.
文摘目的评价超声引导下右美托咪定混合罗哌卡因髂筋膜间隙阻滞(FICB)对小儿髋部手术的镇痛效果。方法选取2014年1月至2015年6月在佛山市中医院择期行单侧发育性髋脱位手术的患儿60例,采用随机数字表法,将患者分为两组(各30例)。观察组气管插管全麻复合超声引导下1μg/kg右美托咪定混合0.2%罗哌卡因1mL/kg FICB,对照组单用气管插管全麻,两组术后均行芬太尼静脉自控镇痛(PCIA)。分别记录术中芬太尼用量,及术后1、2、4、8、12、24、48h的患儿哭泣、呼吸、循环、表情和睡眠疼痛行为学评分,PCIA按压次数,记录不良反应发生情况。结果与对照组比较,观察组术中芬太尼用量显著减少(49.68±15.29μg vs 68.55±20.03μg,t=4.102,P<0.05),术后各时点CRIES疼痛行为学评分(t=3.644~21.610)及PCIA按压次数(t=3.260~31.770)显著低于对照组(均P<0.05),两组均未见有呼吸抑制。观察组恶心呕吐发生2例(6.67%),对照组恶心呕吐发生6例(20.00%)(x~=2.308,P=0.129);观察组瘙痒发生1例(3.33%),对照组瘙痒发生4例(13.33%)(x^2=1.964,P=0.161)。结论超声引导下1μg/kg右美托咪定混合0.2%罗哌卡因1mL/kg FICB可有效缓解小儿发育性髋脱位(DDH)手术患者疼痛,且无明显不良反应,镇痛效果确切持久,实施方法简便易行。
