Study on the Analgesic Efficacy of Femoral Nerve Block for Post-Hip Arthroscopy Pain.

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY Pain and Therapy Pub Date : 2024-11-15 DOI:10.1007/s40122-024-00681-8

Mengwen Xue, Li Zhang, Ruiping Bai, Rui An, Jiarui Li, Xin Shen

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Abstract

Introduction: Postoperative pain management is challenging for hip arthroscopy, and the effectiveness and specific protocols of femoral nerve block (FNB) in hip surgeries remain insufficient. Therefore, we designed this study to investigate the analgesic efficacy and optimal drug concentrations of FNB after hip arthroscopy.

Methods: A total of 148 patients undergoing hip arthroscopy were included and randomly divided into three groups: 0.3% ropivacaine FNB group, 0.4% ropivacaine FNB group, and 0.4% ropivacaine intra-articular injection (IAI) group (positive control). The main outcomes included dynamic and static visual analog scale (VAS) scores at various time points postoperatively, total intraoperative remifentanil consumption, and cumulative consumption of morphine within 24 h postoperatively. Secondary outcomes included total intraoperative dexmedetomidine consumption, RASMAY sedation scores, and patients' satisfaction scores postoperatively.

Results: Both FNB and IAI anesthesia were shown to be safe for post-hip arthroscopy analgesia. Compared with IAI anesthesia, FNB showed no significant differences in analgesic effect within 12 h postoperatively but had a better analgesic effect after 24 h and lower remifentanil consumption intraoperatively. Group 0.4% ropivacaine showed lower dynamic VAS scores within the first 12 h compared with 0.3% ropivacaine for FNB, however, there were no significant differences in patient satisfaction and sedation, and postoperative ambulation was delayed, indicating that the higher concentration of ropivacaine correlated with a longer time to ambulation. The IAI group had greater intraoperative opioid consumption and more side effects.

Conclusions: Compared with IAI anesthesia, FNB can better alleviate post-hip arthroscopy pain and reduce opioid consumption. However, it requires specialized equipment and technical support and carries a certain risk of puncture.

Trial registration: Chinese Clinical Trials Registry (ChiCTR2400091579).

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股神经阻滞治疗髋关节镜术后疼痛的镇痛效果研究

简介：髋关节镜手术的术后疼痛治疗具有挑战性，股神经阻滞（FNB）在髋关节手术中的有效性和具体方案仍不充分。因此，我们设计了这项研究来探讨髋关节镜术后股神经阻滞的镇痛效果和最佳药物浓度：共纳入 148 名接受髋关节镜手术的患者，随机分为三组：0.3% 罗哌卡因 FNB 组、0.4% 罗哌卡因 FNB 组和 0.4% 罗哌卡因关节内注射（IAI）组（阳性对照）。主要结果包括术后不同时间点的动态和静态视觉模拟量表（VAS）评分、术中瑞芬太尼总用量和术后24小时内的吗啡累积用量。次要结果包括术中右美托咪定总用量、RASMAY镇静评分和患者术后满意度评分：结果表明，FNB 和 IAI 麻醉对髋关节镜术后镇痛都是安全的。与 IAI 麻醉相比，FNB 在术后 12 小时内的镇痛效果无明显差异，但在 24 小时后镇痛效果更好，术中瑞芬太尼用量更少。与 0.3% 罗哌卡因的 FNB 相比，0.4% 罗哌卡因组在最初 12 小时内的动态 VAS 评分较低，但患者满意度和镇静效果无明显差异，术后下床活动时间推迟，表明罗哌卡因浓度越高，下床活动时间越长。IAI组术中阿片类药物消耗量更大，副作用更多：结论：与IAI麻醉相比，FNB能更好地缓解髋关节镜术后疼痛并减少阿片类药物的消耗。结论：与IAI麻醉相比，FNB能更好地缓解髋关节镜术后疼痛，减少阿片类药物的消耗，但需要专业设备和技术支持，并有一定的穿刺风险：试验注册：中国临床试验注册中心（ChiCTR2400091579）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.