Manman Liu, Wanxia Xiong, Jie Liu, Biling Wu, Youwen Chen, Yuejiao Song, Xiaoru Lin, Ming Ding, Chao Liang
{"title":"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。","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":"<p><strong>Objective: </strong>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).</p><p><strong>Design: </strong>Retrospective matched cohort study (1:1 propensity score matching).</p><p><strong>Setting: </strong>Single-center analysis of CLTI patients undergoing LER.</p><p><strong>Participants: </strong>216 matched pairs (total n = 432) selected from 505 eligible patients.</p><p><strong>Interventions: </strong>FICB-SNB (n = 216) versus MAC (n= 216).</p><p><strong>Measurements & main results: </strong>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).</p><p><strong>Secondary outcomes: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","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":"{\"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\":\"<p><strong>Objective: </strong>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).</p><p><strong>Design: </strong>Retrospective matched cohort study (1:1 propensity score matching).</p><p><strong>Setting: </strong>Single-center analysis of CLTI patients undergoing LER.</p><p><strong>Participants: </strong>216 matched pairs (total n = 432) selected from 505 eligible patients.</p><p><strong>Interventions: </strong>FICB-SNB (n = 216) versus MAC (n= 216).</p><p><strong>Measurements & main results: </strong>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).</p><p><strong>Secondary outcomes: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"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}","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}
Combined Fascia Iliaca Compartment-Sciatic Nerve Blocks Reduce Early Cardiovascular Events in Chronic Limb-Threatening Ischemia: A Propensity Score-Matched Retrospective Study.
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.
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.
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