Iliopsoas plane block does not improve pain after primary total hip arthroplasty in the presence of multimodal analgesia: a single institution randomized controlled trial.

IF 5.1 2区 医学 Q1 ANESTHESIOLOGY
Ji Yeong Kim, Jong Seok Lee, Ji Young Kim, Eun Jang Yoon, Wootaek Lee, Seungyeon Lee, Do-Hyeong Kim
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引用次数: 0

Abstract

Background: The clinical analgesic efficacy of iliopsoas plane block remains a subject of discussion. This study aimed to assess the analgesic efficacy of iliopsoas plane block under general anesthesia using multimodal analgesia.

Methods: Fifty-six adult patients who underwent elective primary hip arthroplasty were enrolled. Patients were randomized to receive either a single-shot iliopsoas plane block (10 mL 0.75% ropivacaine with 1:200 000 epinephrine) or a sham block (10 mL normal saline). All patients received general anesthesia, multimodal analgesia (preoperative buprenorphine patch, 5 µg/h), intraoperative intravenous dexamethasone (8 mg) and nefopam (20 mg), and round-the-clock acetaminophen and celecoxib. The primary outcome was the numeric rating scale pain score at rest 6 hour after surgery.

Results: Iliopsoas plane block did not have a notable advantage over the sham block in terms of pain relief at rest, as assessed by the numeric rating scale score, 6 hour after total hip arthroplasty (iliopsoas plane block: median, 4.0; IQR, 2.0-5.8; sham: median, 5.5; IQR, 2.3-6.8; median difference, -1.0; 95% CI -2.0 to 0.0; p≥0.999). Linear mixed model analysis showed no differences in pain scores, opioid consumption, quadriceps strength, or quality of recovery between the groups.

Conclusions: Iliopsoas plane block did not improve postoperative analgesia following total hip arthroplasty under general anesthesia with a multimodal analgesic regimen. The blockade of sensory femoral branches supplying the anterior hip capsule using iliopsoas plane block may not yield additional benefits concerning patient outcomes in the aforementioned clinical context.

Trial registration number: NCT05212038, https://clinicaltrials.gov/ct2/show/NCT05212038.

髂腰肌平面阻滞不能改善初级全髋关节置换术后多模式镇痛的疼痛:一项单机构随机对照试验。
背景:髂腰肌平面阻滞的临床镇痛效果仍是一个讨论主题。本研究旨在评估髂腰肌平面阻滞在全身麻醉下使用多模式镇痛的镇痛效果:方法:56 名成年患者接受了选择性初级髋关节置换术。患者被随机分配接受单次髂腰肌平面阻滞(10 mL 0.75% 罗哌卡因加 1:200 000 肾上腺素)或假阻滞(10 mL 生理盐水)。所有患者都接受了全身麻醉、多模式镇痛(术前丁丙诺啡贴片,5 µg/h)、术中静脉注射地塞米松(8 毫克)和奈福泮(20 毫克),以及全天候对乙酰氨基酚和塞来昔布。主要结果是术后6小时休息时的疼痛评分:结果:在全髋关节置换术后6小时休息时疼痛缓解方面,髂腰肌平面阻滞与假阻滞相比没有明显优势(髂腰肌平面阻滞:中位数,4.0;IQR,2.0-5.8;假阻滞:中位数,5.5;IQR,2.3-6.8;中位数差异,-1.0;95% CI -2.0至0.0;P≥0.999)。线性混合模型分析显示,两组在疼痛评分、阿片类药物用量、股四头肌力量或恢复质量方面没有差异:结论:髂腰肌平面阻滞并不能改善全身麻醉下采用多模式镇痛方案进行全髋关节置换术后的镇痛效果。在上述临床情况下,使用髂腰肌平面阻滞对供应髋关节前囊的股感觉分支进行阻滞可能不会对患者的预后产生额外的益处:NCT05212038, https://clinicaltrials.gov/ct2/show/NCT05212038.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.50
自引率
11.80%
发文量
175
审稿时长
6-12 weeks
期刊介绍: Regional Anesthesia & Pain Medicine, the official publication of the American Society of Regional Anesthesia and Pain Medicine (ASRA), is a monthly journal that publishes peer-reviewed scientific and clinical studies to advance the understanding and clinical application of regional techniques for surgical anesthesia and postoperative analgesia. Coverage includes intraoperative regional techniques, perioperative pain, chronic pain, obstetric anesthesia, pediatric anesthesia, outcome studies, and complications. Published for over thirty years, this respected journal also serves as the official publication of the European Society of Regional Anaesthesia and Pain Therapy (ESRA), the Asian and Oceanic Society of Regional Anesthesia (AOSRA), the Latin American Society of Regional Anesthesia (LASRA), the African Society for Regional Anesthesia (AFSRA), and the Academy of Regional Anaesthesia of India (AORA).
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