Utility of multimodal analgesia with fascia iliaca blockade for acute pain management following hip arthroscopy

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• 作者：Aaron J. Krych (1)
  Sean Baran (1)
  Scott A. Kuzma (1)
  Hugh M. Smith (2)
  Rebecca L. Johnson (2)
  Bruce A. Levy (1)
  
• 关键词：Fascia iliaca blockade ; Multimodal analgesia ; Hip arthroscopy ; Acute pain management
• 刊名：Knee Surgery, Sports Traumatology, Arthroscopy
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：22
• 期：4
• 页码：843-847
• 全文大小：241 KB
• 参考文献：1. Atchabahian A, Brown A (1994) Postoperative neuropathy following fascia iliaca compartment blockade. Anesthesiology 94:534-36 CrossRef
  2. Baker JF, Byrne DP, Hunter K, Mulhall KJ (2011) Post-operative opiate requirements after hip arthroscopy. Knee Surg Sports Traumatol Arthrosc 19(8):1399-402. doi:10.1007/s00167-010-1248-4 CrossRef
  3. Baker JF, McGuire CM, Byrne DP, Hunter K, Eustace N, Mulhall KJ (2011) Analgesic control after hip arthroscopy: a randomised, double-blinded trial comparing portal with intra-articular infiltration of bupivacaine. Hip Int 21(3):373-77. doi:10.5301/hip.2011.8390 CrossRef
  4. Birnbaum K, Prescher A, Hessler S, Heller K (1997) The sensory innervation of the hip joint–an anatomical study. Surg Radiol Anat 19(6):371-75 CrossRef
  5. Blackford D, Westhoffen P (2009) Accidental bladder puncture: a complication of a modified fascia iliaca block. Anaesth Intensive Care 37(1):140-41
  6. Borg G (1998) Borg’s perceived exertion and pain scales. Human Kinetics, Champaign
  7. Candal-Couto JJ, McVie JL, Haslam N, Innes AR, Rushmer J (2005) Pre-operative analgesia for patients with femoral neck fractures using a modified fascia iliaca block technique. Injury 36(4):505-10. doi:10.1016/j.injury.2004.10.015 CrossRef
  8. Capdevila X, Coimbra C, Choquet O (2005) Approaches to the lumbar plexus: success, risks, and outcome. Reg Anesth Pain Med 30:150-62
  9. Dalens B, Vanneuville G, Tanguy A (1989) Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesth Analg 69(6):705-13
  10. DeLoach LJ, Higgins MS, Caplan AB, Stiff JL (1998) The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg 86(1):102-06
  11. Dolan J, Williams A, Murney E, Smith M, Kenny GN (2008) Ultrasound guided fascia iliaca block: a comparison with the loss of resistance technique. Reg Anesth Pain Med 33(6):526-31
  12. Dulaney-Cripe E, Hadaway S, Bauman R, Trame C, Smith C, Sillaman B, Laughlin R (2012) A continuous infusion fascia iliaca compartment block in hip fracture patients: a pilot study. J Clin Med Res 4(1):45-8. doi:10.4021/jocmr724w
  13. Elkhodair S, Mortazavi J, Chester A, Pereira M (2011) Single fascia iliaca compartment block for pain relief in patients with fractured neck of femur in the emergency department: a pilot study. Eur J Emerg Med 18(6):340-43. doi:10.1097/MEJ.0b013e32834533dd CrossRef
  14. Foss NB, Kristensen BB, Bundgaard M, Bak M, Heiring C, Virkelyst C, Hougaard S, Kehlet H (2007) Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. Anesthesiology 106(4):773-78. doi:10.1097/01.anes.0000264764.56544.d2 CrossRef
  15. Lee EM, Murphy KP, Ben-David B (2008) Postoperative analgesia for hip arthroscopy: combined L1 and L2 paravertebral blocks. J Clin Anesth 20(6):462-65. doi:10.1016/j.jclinane.2008.04.012 CrossRef
  16. Monzon DG, Iserson KV, Vazquez JA (2007) Single fascia iliaca compartment block for post-hip fracture pain relief. J Emerg Med 32(3):257-62. doi:10.1016/j.jemermed.2006.08.011 CrossRef
  17. Paut O, Sallabery M, Schreiber-Deturmeny E, Rémond C, Bruguerolle B, Camboulives J (2001) Continuous fascia iliaca compartment block in children: a prospective evaluation of plasma bupivacaine concentrations, pain scores, and side effects. Anesth Analg 92(5):1159-163 CrossRef
  18. Pavy E, Compere V, Fourdrinier V, Beghin CE, Dujardin F, Dureuil B (2007) Evaluation of postoperative analgesia with continuous iliofascial nerve sheath block after total hip arthroplasty replacement: a pilot study. Ann Fr Anesth Reanim 26(2):125-31. doi:10.1016/j.annfar.2006.10.026 CrossRef
  19. Robertson WJ, Kelly BT (2008) The safe zone for hip arthroscopy: a cadaveric assessment of central, peripheral, and lateral compartment portal placement. Arthroscopy 24(9):1019-026. doi:10.1016/j.arthro.2008.05.008 CrossRef
  20. Shelley BG, Haldane GJ (2006) Pneumoretroperitoneum as a consequence of fascia iliaca block. Reg Anesth Pain Med 31(6):582-83. doi:10.1016/j.rapm.2006.08.009
  21. Stevens M, Harrison G, McGrail M (2007) A modified fascia iliaca compartment block has significant morphine-sparing effect after total hip arthroplasty. Anaesth Intensive Care 35(6):949-52
  22. Ward JP, Albert DB, Altman R, Goldstein RY, Cuff G, Youm T (2012) Are femoral nerve blocks effective for early postoperative pain management after hip arthroscopy? Arthroscopy 28(8):1064-069. doi:10.1016/j.arthro.2012.01.003 CrossRef
  23. Wongswadiwat M, Pathanon P, Sriraj W, Yimyaem PR, Bunthaothuk S (2012) Single injection fascia iliaca block for pain control after arthroscopic anterior cruciate ligament reconstruction: a randomized, controlled trial. J Med Assoc Thai 95(11):1418-424
  24. Woods G, O’Connor D, Calder C (2006) Continuous femoral nerve block versus intra-articular injection for pain control after anterior cruciate ligament reconstruction. Am J Sports Med 34:1328-333 CrossRef
  
• 作者单位：Aaron J. Krych (1)
  Sean Baran (1)
  Scott A. Kuzma (1)
  Hugh M. Smith (2)
  Rebecca L. Johnson (2)
  Bruce A. Levy (1)
  
  1. Department of Orthopedic Surgery and The Sports Medicine Center, Mayo Clinic and Mayo Foundation, 200 First Street SW, Rochester, MN, 55905, USA
  2. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
  
• ISSN：1433-7347

文摘

Purpose The purpose of this study was to evaluate the utility of multimodal analgesia with fascia iliaca blockade and for acute pain control in patients undergoing hip arthroscopy. Methods Thirty consecutive patients undergoing primary hip arthroscopy were prospectively studied. All patients were treated preoperatively with ultrasound-guided single injection fascia iliaca blockade and multimodal analgesia. Data collected included post-operative nausea, numeric rating scale (NRS) pain scores during rest and activity, opioid consumption during the first five days (recorded as tablets of 5?mg hydrocodone/500?mg acetaminophen) and overall patient satisfaction with analgesia. Results This study included 23 female and 7 male patients with a median age of 35?years (range 14-8). No patient required medication for post-operative nausea. The overall NRS scores were an average of 3.9 on day 0, 3.6 on day 1, 3.4 on day 2, 2.9 on day 3, 3.0 on day 4 and 2.7 on day 5. The average tablets of opioid taken were 1.5 on day 0, 1.2 on day 1, 1.3 on day 2, 1.0 on day 3, 1.1 on day 4 and 0.9 on day 5. Overall, 20 patients rated their post-operative pain control as very satisfied (67?%), and 10 patients as satisfied (33?%). There were no complications or side effects from the fascia iliaca blockade. Conclusion In this prospective study, multimodal analgesia with fascia iliaca blockade following hip arthroscopy was safe and effective. The quality of early post-operative analgesia provided by the fascia iliaca blockade was excellent and resulted in low opioid consumption, high quality of pain relief and high overall patient satisfaction. Level of evidence Prospective case series, Level II.