髋部骨折患者的术前疼痛管理:盲筋膜髂腔室阻滞与超声引导股神经阻滞的比较——一项随机对照试验

Pub Date : 2020-11-06 DOI:10.4236/ojanes.2020.1011033
J. Bangshoej, Thomas Thougaard, H. Fjeldsøe-Nielsen, S. Viggers
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引用次数: 2

摘要

简介:盲筋膜髂腔室阻滞(FICB)和超声引导股神经阻滞(FNB)是两种外周神经阻滞,常用于丹麦急诊科髋部骨折患者的术前疼痛管理。本研究的目的是比较这两种类型的周围神经阻滞在髋部骨折患者术前疼痛管理方面的疗效。方法:采用随机对照研究。主要结局是在阻滞给药后3小时,静止时和被动抬腿试验后,NRS疼痛评分等于3分或更少的患者比例。结果:共纳入88例患者,统计分析67例,其中FICB组33例,FNB组34例。结果显示,与纳入时相比,FICB或FNB治疗后3小时以上NRS评分的患者比例显著降低。FICB患者与FNB患者在休息或被动抬腿后的疼痛评分无显著差异(p = 0.25和p = 0.86)。结论:盲法FICB和超声引导下FNB在髋部骨折患者术前疼痛管理中是有效的。结果表明,两种类型的周围神经阻滞在提供术前疼痛管理方面同样有效。
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Preoperative Pain Management of Patients with Hip Fractures: Blind Fascia Iliaca Compartment Block Compared to Ultrasound Guided Femoral Nerve Block—A Randomized Controlled Trial
Introduction: Blind fascia iliaca compartment block (FICB) and ultrasound guided femoral nerve block (FNB) are two types of peripheral nerve blocks, commonly used in preoperative pain management in patients with hip fractures in Danish emergency departments. The aim of this study was to compare the efficacy in pain management of these two types of peripheral nerve blocks in the preoperative period in patients with hip fractures. Method: We performed a randomized controlled study. The primary outcome was the proportion of patients with a numeric rating scale (NRS) pain score equal to three or less at rest and after passive leg raise test three hours after block administration. Results: A total of 88 patients were included in the study and 67 patients in the statistical analysis with 33 in the FICB group and 34 in the FNB group. The results showed a significant reduction in the proportion of patients with an NRS score higher than three, three hours after administration of either FICB or FNB compared to at inclusion. There was no significant difference in pain scores between patients receiving FICB versus patients receiving FNB at rest or after passive leg raise (p = 0.25 and p = 0.86, respectively). Conclusion: Blind FICB and ultrasound guided FNB were effective in preoperative pain management in patients with hip fractures. The results showed that the two types of peripheral nerve blocks were equally efficient in providing pain management in the preoperative period.
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