{"title":"腰椎棘突平面阻滞与腹股沟下筋膜髂内隔间阻滞治疗全髋关节置换术后疼痛:随机临床试验","authors":"Ahmet Kaciroglu, Mursel Ekinci, Mustafa Dikici, Omer Aydemir, Oznur Demiroluk, Dilek Erdogan, Birzat Emre Golboyu, Selcuk Alver, Bahadir Ciftci, Hande Gurbuz","doi":"10.1093/pm/pnad166","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the effectiveness of ultrasound-guided facia iliaca compartment (FIC) and erector spinae plane (ESP) blocks in managing postoperative pain after total hip arthroplasty surgery.</p><p><strong>Methods: </strong>A total of 60 patients were randomized into 2 groups (n = 30): one that received FIC blocks and one that received ESP blocks. FIC and ESP blocks were performed with 30 mL 0.25% bupivacaine at the end of the surgery. The patients received intravenous tramadol and patient-controlled postoperative analgesia. The pain scores, opioid consumption, and adverse events were recorded.</p><p><strong>Results: </strong>The dynamic pain scores on movement in the postoperative first hour were significantly lower in the ESP block group than in the FIC block group (3 [2-4] vs 4 [2-5], respectively; P = .035). Data are expressed as median (25th-75th percentiles). Postoperative opioid consumption within the first postoperative 8 hours was significantly higher in the FIC block group than in the ESP block group (80 mg [61-100] vs 100 mg [80-120], respectively; P = .010). The adverse effects of opioids did not differ between the 2 groups.</p><p><strong>Conclusion: </strong>ESP and infrainguinal FIC blocks provided similar postoperative analgesia 24 hours after total hip arthroplasty. The ESP block is more beneficial than the FIC block in terms of pain scores and opioid consumption in the early hours of the postoperative period.</p><p><strong>Trial registration: </strong>www.ClinicalTrials.gov (ID: NCT05621161).</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lumbar erector spinae plane block versus infrainguinal fascia iliaca compartment block for pain management after total hip arthroplasty: a randomized clinical trial.\",\"authors\":\"Ahmet Kaciroglu, Mursel Ekinci, Mustafa Dikici, Omer Aydemir, Oznur Demiroluk, Dilek Erdogan, Birzat Emre Golboyu, Selcuk Alver, Bahadir Ciftci, Hande Gurbuz\",\"doi\":\"10.1093/pm/pnad166\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>We aimed to evaluate the effectiveness of ultrasound-guided facia iliaca compartment (FIC) and erector spinae plane (ESP) blocks in managing postoperative pain after total hip arthroplasty surgery.</p><p><strong>Methods: </strong>A total of 60 patients were randomized into 2 groups (n = 30): one that received FIC blocks and one that received ESP blocks. FIC and ESP blocks were performed with 30 mL 0.25% bupivacaine at the end of the surgery. The patients received intravenous tramadol and patient-controlled postoperative analgesia. The pain scores, opioid consumption, and adverse events were recorded.</p><p><strong>Results: </strong>The dynamic pain scores on movement in the postoperative first hour were significantly lower in the ESP block group than in the FIC block group (3 [2-4] vs 4 [2-5], respectively; P = .035). Data are expressed as median (25th-75th percentiles). Postoperative opioid consumption within the first postoperative 8 hours was significantly higher in the FIC block group than in the ESP block group (80 mg [61-100] vs 100 mg [80-120], respectively; P = .010). The adverse effects of opioids did not differ between the 2 groups.</p><p><strong>Conclusion: </strong>ESP and infrainguinal FIC blocks provided similar postoperative analgesia 24 hours after total hip arthroplasty. The ESP block is more beneficial than the FIC block in terms of pain scores and opioid consumption in the early hours of the postoperative period.</p><p><strong>Trial registration: </strong>www.ClinicalTrials.gov (ID: NCT05621161).</p>\",\"PeriodicalId\":19744,\"journal\":{\"name\":\"Pain Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-04-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pain Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/pm/pnad166\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/pm/pnad166","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:我们旨在评估超声引导下的髂骨面(FIC)和竖脊平面(ESP)阻滞治疗全髋关节置换术后疼痛的效果:共有 60 名患者被随机分为两组(n = 30):手术结束后使用 30 mL 0.25% 布比卡因进行 FIC 和 ESP 阻滞。患者接受静脉注射曲马多和患者自控的术后镇痛。对疼痛评分、阿片类药物用量和不良反应进行了记录:结果:ESP阻滞组术后1小时活动时的动态疼痛评分明显低于FIC阻滞组[分别为3(2-4) vs. 4(2-5); p = 0.035]。术后 8 小时内,FIC 阻滞组的阿片类药物用量明显高于 ESP 阻滞组[分别为 80 毫克(61-100)对 100 毫克(80-120);P = 0.010]。两组间阿片类药物的不良反应没有差异:结论:ESP阻滞和腹股沟下FIC阻滞在全髋关节置换术后24小时提供的术后镇痛效果相似。就术后早期疼痛评分和阿片类药物用量而言,ESP阻滞比FIC阻滞更有效。
Lumbar erector spinae plane block versus infrainguinal fascia iliaca compartment block for pain management after total hip arthroplasty: a randomized clinical trial.
Objective: We aimed to evaluate the effectiveness of ultrasound-guided facia iliaca compartment (FIC) and erector spinae plane (ESP) blocks in managing postoperative pain after total hip arthroplasty surgery.
Methods: A total of 60 patients were randomized into 2 groups (n = 30): one that received FIC blocks and one that received ESP blocks. FIC and ESP blocks were performed with 30 mL 0.25% bupivacaine at the end of the surgery. The patients received intravenous tramadol and patient-controlled postoperative analgesia. The pain scores, opioid consumption, and adverse events were recorded.
Results: The dynamic pain scores on movement in the postoperative first hour were significantly lower in the ESP block group than in the FIC block group (3 [2-4] vs 4 [2-5], respectively; P = .035). Data are expressed as median (25th-75th percentiles). Postoperative opioid consumption within the first postoperative 8 hours was significantly higher in the FIC block group than in the ESP block group (80 mg [61-100] vs 100 mg [80-120], respectively; P = .010). The adverse effects of opioids did not differ between the 2 groups.
Conclusion: ESP and infrainguinal FIC blocks provided similar postoperative analgesia 24 hours after total hip arthroplasty. The ESP block is more beneficial than the FIC block in terms of pain scores and opioid consumption in the early hours of the postoperative period.
期刊介绍:
Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.