Efficacy of iliopsoas plane block for patients undergoing hip arthroscopy: a prospective, triple-blind, randomized, placebo-controlled trial.

Autor:	Jessen C; Department of Anesthesiology and Intensive Care, PeriSCOP, Horsens Regional Hospital, Horsens, Denmark jessen_chr@hotmail.com.; Department of Clinical Medicine, Aarhus University Faculty of Health, Aarhus, Denmark., Brix LD; Department of Anesthesiology and Intensive Care, PeriSCOP, Horsens Regional Hospital, Horsens, Denmark.; Department of Clinical Medicine, Aarhus University Faculty of Health, Aarhus, Denmark., Nielsen TD; Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark., Espelund US; Department of Anesthesiology and Intensive Care, PeriSCOP, Horsens Regional Hospital, Horsens, Denmark.; Department of Clinical Medicine, Aarhus University Faculty of Health, Aarhus, Denmark., Lund B; Department of Clinical Medicine, Aarhus University Faculty of Health, Aarhus, Denmark.; Department of Orthopedic Surgery, H-Hip, Horsens Regional Hospital, Horsens, Denmark., Bendtsen TF; Department of Clinical Medicine, Aarhus University Faculty of Health, Aarhus, Denmark.; Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.
Jazyk:	angličtina
Zdroj:	Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2023 Nov 30. Date of Electronic Publication: 2023 Nov 30.
DOI:	10.1136/rapm-2023-104989
Abstrakt:	Background: Intraoperative stretching of the hip joint capsule often generates severe pain during the first 3 hours after hip arthroscopy. The short-lived severe pain mandates high opioid consumption, which may result in adverse events and delay recovery. The femoral nerve nociceptors are located anteriorly in the hip joint capsule. A femoral nerve block reduces pain and opioid demand after hip arthroscopy. It impedes, however, ambulation and home discharge after outpatient surgery. The iliopsoas plane block selectively anesthetizes the femoral sensory nerve branches innervating the hip joint capsule without compromising ambulation. We aimed to assess reduction of opioid consumption after iliopsoas plane block during the short-lived painful postsurgical period of time after hip arthroscopy. Methods: In a randomized, triple-blind trial, 50 patients scheduled for hip arthroscopy in general anesthesia were allocated to active or placebo iliopsoas plane block. The primary outcome was opioid consumption during the first three postoperative hours in the postanesthesia care unit. Secondary outcomes included pain, nausea, and ability to ambulate. Results: Forty-nine patients were analyzed for the primary outcome. The mean 3-hour intravenous morphine equivalent consumption in the iliopsoas plane block group was 10.4 mg vs 23.8 mg in the placebo group (p<0.001). No intergroup differences were observed for the secondary outcomes during the postoperative follow-up. Conclusion: An iliopsoas plane block reduces opioid consumption after hip arthroscopy. The reduction of opioid consumption during the clinically relevant 3-hour postsurgical period of time was larger than 50% for active versus placebo iliopsoas plane block in this randomized, triple-blind trial. Competing Interests: Competing interests: None declared. (© American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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