Combined Fascia Iliaca Compartment-Sciatic Nerve Blocks Reduce Early Cardiovascular Events in Chronic Limb-Threatening Ischemia: A Propensity Score-Matched Retrospective Study.

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia Pub Date : 2025-08-14 DOI:10.1053/j.jvca.2025.08.009

Manman Liu, Wanxia Xiong, Jie Liu, Biling Wu, Youwen Chen, Yuejiao Song, Xiaoru Lin, Ming Ding, Chao Liang

{"title":"Combined Fascia Iliaca Compartment-Sciatic Nerve Blocks Reduce Early Cardiovascular Events in Chronic Limb-Threatening Ischemia: A Propensity Score-Matched Retrospective Study.","authors":"Manman Liu, Wanxia Xiong, Jie Liu, Biling Wu, Youwen Chen, Yuejiao Song, Xiaoru Lin, Ming Ding, Chao Liang","doi":"10.1053/j.jvca.2025.08.009","DOIUrl":null,"url":null,"abstract":"Objective: To compare postoperative outcomes between combined fascia iliaca compartment-sciatic nerve blockade (FICB-SNB) and monitored anesthesia care (MAC) in patients with chronic limb-threatening ischemia (CLTI) undergoing lower-extremity revascularization (LER).Design: Retrospective matched cohort study (1:1 propensity score matching).Setting: Single-center analysis of CLTI patients undergoing LER.Participants: 216 matched pairs (total n = 432) selected from 505 eligible patients.Interventions: FICB-SNB (n = 216) versus MAC (n= 216).Measurements & main results: Primary outcomes: Compared to MAC, FICB-SNB did not significantly reduce in-hospital major adverse cardiovascular events (MACE) (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.18-1.32; p = 0.15) or 1-year MACE (p > 0.05).Secondary outcomes: FICB-SNB demonstrated superior postoperative analgesia, reducing rest pain by 67% (OR, 0.33; 95% CI, 0.23-0.48; p < 0.001). No differences were observed in myocardial injury after noncardiac surgery, complications, or amputation rates (p > 0.05 for all).Conclusions: FICB-SNB improves analgesia but does not significantly reduce short- or long-term MACE. The trend toward lower in-hospital MACE suggests transient intraoperative cardiovascular stabilization not sustained at 1 year. A prospective randomized trial with standardized protocols to control confounders and validate clinical trends is warranted.","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiothoracic and vascular anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jvca.2025.08.009","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To compare postoperative outcomes between combined fascia iliaca compartment-sciatic nerve blockade (FICB-SNB) and monitored anesthesia care (MAC) in patients with chronic limb-threatening ischemia (CLTI) undergoing lower-extremity revascularization (LER).

Design: Retrospective matched cohort study (1:1 propensity score matching).

Setting: Single-center analysis of CLTI patients undergoing LER.

Participants: 216 matched pairs (total n = 432) selected from 505 eligible patients.

Interventions: FICB-SNB (n = 216) versus MAC (n= 216).

Measurements & main results: Primary outcomes: Compared to MAC, FICB-SNB did not significantly reduce in-hospital major adverse cardiovascular events (MACE) (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.18-1.32; p = 0.15) or 1-year MACE (p > 0.05).

Secondary outcomes: FICB-SNB demonstrated superior postoperative analgesia, reducing rest pain by 67% (OR, 0.33; 95% CI, 0.23-0.48; p < 0.001). No differences were observed in myocardial injury after noncardiac surgery, complications, or amputation rates (p > 0.05 for all).

Conclusions: FICB-SNB improves analgesia but does not significantly reduce short- or long-term MACE. The trend toward lower in-hospital MACE suggests transient intraoperative cardiovascular stabilization not sustained at 1 year. A prospective randomized trial with standardized protocols to control confounders and validate clinical trends is warranted.

查看原文本刊更多论文

髂筋膜-坐骨神经联合阻滞可减少慢性肢体缺血患者早期心血管事件：一项倾向评分匹配的回顾性研究。

目的：比较髂筋膜间室-坐骨神经联合阻滞（FICB-SNB）和监护麻醉护理（MAC）在慢性肢体威胁性缺血（CLTI）患者行下肢血运重建术（LER）的术后效果。设计：回顾性匹配队列研究（1:1倾向评分匹配）。背景：接受LER治疗的CLTI患者的单中心分析。参与者：从505例符合条件的患者中选择216对配对（总n = 432）。干预措施：FICB-SNB （n= 216）与MAC （n= 216）。测量和主要结果：主要结局：与MAC相比，FICB-SNB没有显著降低院内主要不良心血管事件（MACE）（优势比[OR]， 0.49； 95%可信区间[CI]， 0.18-1.32; p = 0.15）或1年MACE （p < 0.05）。次要结局：FICB-SNB显示出良好的术后镇痛效果，使静息痛减少67% （OR, 0.33; 95% CI, 0.23-0.48; p < 0.001）。非心脏手术后心肌损伤、并发症或截肢率均无差异（p < 0.05）。结论：FICB-SNB可改善镇痛，但不能显著降低短期或长期MACE。较低的住院MACE趋势表明术中短暂的心血管稳定不能持续1年。有必要进行一项具有标准化方案的前瞻性随机试验，以控制混杂因素并验证临床趋势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of cardiothoracic and vascular anesthesia 医学-呼吸系统

CiteScore

4.80

自引率

17.90%

发文量

606

审稿时长

37 days

期刊介绍： The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.