Unit:
Κατεύθυνση Καρδιοαναπνευστική ΑναζωογόνησηLibrary of the School of Health Sciences
Author:
Christodoulopoulou Argyro
Supervisors info:
Τσαρουχά Αθανασία, Επίκουρος Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ.
Χαλκιάς Αθανάσιος, Επίκουρος Καθηγητής, Ιατρική Σχολή, Πανεπιστήμιο Θεσσαλίας.
Μελεμενή Αικατερίνη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ.
Original Title:
Μετεγχειρητική αναλγησία σε ολική αρθροπλαστική ισχίου. Υπαραχνοειδής αναισθησία με ή χωρίς αποκλεισμό της λαγόνιας περιτονίας.
Translated title:
Effectiveness of subarachnoid anesthesia vs subarachnoid anesthesia plus fascia iliaca compartment block in patients undergoing total hip arthroplasty.
Summary:
Introduction : Hip surgery has increased in recent years, particularly in elderly patients. The most commonly used regional technique in total hip arthroplasty is subarachnoid anesthesia which can be supplemented by fascia iliaca compartment block.
Aim: To assess whether subarachnoid anesthesia with or without fascia iliaca compartment block provides better postoperative analgesia than subarachnoid anesthesia alone.
Material and Method: Patients enrolled in the study were divided into two groups (A, B). In the first group (group A) patients received regional anesthesia with ropivacaine 0.75% at a dose of 15-20 mg depending on the somatometric characteristics. In the second group (group B) the patients received subarachnoid anesthesia as in the first group but also after the end of the surgery they received fascia iliaca compartment block with 30 ml of ropivacaine 0.5%.
Results: in both groups, for the accomplishment of spine anesthesia time ranged from 20 to 25 minutes and there are no statistically significant differences (p = 0.421). There are no statistically significant differences between the two anesthesia techniques (p = 0.091) in terms of withdrawal time. Pain prior to surgery is maximal for the vast majority of patients in both groups (p = 0.917). A statistically significant difference was found between the two groups of patients (p = 0.048) in terms of position quality. The majority of patients in both anesthesia techniques showed no intraoperative complications and no statistically significant differences were found (p = 0.113). Similarly, the majority of patients in both anesthesia techniques showed no post-operative complications and no statistically significant differences were found (p = 0.436). Statistically significant differences were found at postoperative analgesic time (p = 0.021). 22.4% of patients in group A did not receive analgesia postoperatively while 47.1% of patients in group B received analgesia for more than two days.
Conclusions: Fascia iliaca compartment block should be considered as a preferred analgesic approach for total hip replacements as documented by a significant reduction in pain postoperatively and by reduced opioid consumption.
Main subject category:
Health Sciences
Keywords:
Subarachnoid anesthesia, Fascia iliaca compartment block, Pain, Analgesia, Total hip arthroplasty
Number of references:
129
