Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study.

IF 2.9 Q1 ANESTHESIOLOGY
Indian Journal of Anaesthesia Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI:10.4103/ija.ija_695_24
Carlos Rodrigues Almeida
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Abstract

Background and aims: The fragile elderly population suffering from hip fractures presents an anaesthetic challenge; therefore, widening the armamentarium for surgical treatment should be sought. This retrospective study presents a new primary anaesthetic method for intramedullary femoral nailing (IMFN) surgery in the context of hip fracture: the sequential proximal iliopsoas compartment (SPIC) block.

Methods: This single-centre retrospective study involved 25 patients aged 80 or older submitted to IMFN surgery. The patients were given a single-shot SPIC block using a total of 25 ml of ropivacaine 0.5% plus dexamethasone 8 mg administered sequentially in the proximal iliopsoas space, divided equally as per two different sites as a primary anaesthetic technique associated with moderate sedation. The outcome measure was the adequacy of the anaesthetic approach. The one-tailed Wilcoxon signed-rank test compared the preoperative numerical pain rating scale (NPRS) with the NPRS at 24 h and the pre-incision with the maximum intraoperative mean arterial pressure.

Results: The patients were successfully anaesthetised, had no vasopressor consumption, had good surgical conditions, and had no complaints recorded. No tachycardia or hypertensive events were noted. No additional opioids were given. No statistically different values were observed when the pre-incisional and intraoperative mean arterial pressure values were compared (P = 0.52), and the preoperative NPRS compared with the NPRS at 24 h showed a statistically significant difference (P < 0.001).

Conclusion: The SPIC block combined only with moderate sedation permits adequate anaesthesia while avoiding the significant risk of neuraxial/sympathetic blockade.

新颖的髂腰肌近端连续阻滞:作为股骨髓内钉手术主要麻醉技术的四合一阻滞:一项回顾性研究。
背景与目的:脆弱的老年人髋部骨折对麻醉提出了挑战;因此,应寻求扩大手术治疗范围。本回顾性研究提出了一种新的用于髋部骨折股骨髓内钉(IMFN)手术的初级麻醉方法:连续髂腰肌近端间室(SPIC)阻滞。方法:本单中心回顾性研究纳入25例80岁及以上接受IMFN手术的患者。患者被给予一次SPIC阻滞,共使用25ml 0.5%罗哌卡因加8mg地塞米松,依次在髂腰肌近端间隙给药,按两个不同部位平均分配,作为初级麻醉技术,伴有中度镇静。结果测量是麻醉方法的充分性。单侧Wilcoxon sign -rank检验将术前数值疼痛评定量表(NPRS)与24 h时的NPRS以及切开前的NPRS与术中最大平均动脉压进行比较。结果:患者麻醉成功,无血管加压素消耗,手术条件良好,无主诉记录。未发现心动过速或高血压事件。没有给予额外的阿片类药物。切口前与术中平均动脉压值比较,差异无统计学意义(P = 0.52),术前NPRS与24h NPRS比较,差异有统计学意义(P < 0.001)。结论:SPIC阻滞仅与适度镇静相结合,可获得充分的麻醉,同时避免了显著的神经轴/交感神经阻滞风险。
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
4.20
自引率
44.80%
发文量
210
审稿时长
36 weeks
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