A Longitudinal Supra-Inguinal Fascia Iliaca Compartment Block Reduces Morphine Consumption After Total Hip Arthroplasty
| Autor: | Kris Vermeylen, F Soetens, Hans Pottel, Marc Van de Velde, Kathleen Croes, Laurence Carlier, Stijn Lambrecht, Matthias Desmet, Imré Van Herreweghe |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Arthroplasty Replacement Hip medicine.medical_treatment law.invention Ilium 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial 030202 anesthesiology law Humans Medicine Ropivacaine Prospective Studies Anesthetics Local Fascia Prospective cohort study Aged Pain Postoperative Morphine business.industry Local anesthetic General Medicine Middle Aged Amides Arthroplasty Surgery Analgesics Opioid Clinical trial Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia Female business 030217 neurology & neurosurgery Autonomic Nerve Block medicine.drug |
| Zdroj: | Regional Anesthesia and Pain Medicine. 42:327-333 |
| ISSN: | 1098-7339 |
| DOI: | 10.1097/aap.0000000000000543 |
| Popis: | Background and Objectives The role of a fascia iliaca compartment block (FICB) for postoperative analgesia after total hip arthroplasty (THA) remains questionable. High-dose local anesthetics and a proximal injection site may be essential for successful analgesia. High-dose local anesthetics may pose a risk for local anesthetic systemic toxicity. We hypothesized that a high-dose longitudinal supra-inguinal FICB is safe and decreases postoperative morphine consumption after anterior approach THA. Methods We conducted a prospective, double blind, randomized controlled trial. Patients scheduled for THA were randomized to group FICB (longitudinal supra-inguinal FICB with 40-mL ropivacaine 0.5%) or group C (control, no block). Standard hypothesis tests (t test or Mann-Whitney U test, χ2 test) were performed to analyze baseline characteristics and outcome parameters. The primary end point of the study was total morphine (mg) consumption at 24 hours postoperatively. Serial total and free ropivacaine serum levels were determined in 10 patients. Results After obtaining ethical committee approval and written informed consent, 88 patients were included. Mean (SD) morphine consumption at 24 hours postoperatively was reduced in group FICB compared to group C: 10.25 (1.64) mg versus 19.0 (2.4) mg (P = 0.004). Using a mean dose of 2.6-mg/kg ropivacaine (range, 2–3.4 mg/kg), none of the patients had total or free ropivacaine levels above the maximum tolerated serum concentration. Conclusions We conclude that a high-dose longitudinal supra-inguinal FICB reduces postoperative morphine requirements after anterior approach THA. Clinical Trials Registry: EU Clinical Trials Register. www.clinicaltrialsregister.eu #2014-002122-12. |
| Databáze: | OpenAIRE |
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