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
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.
