Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2021; 9(15): 3567-3575
Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3567
Ultrasound-guided, direct suprainguinal injection for fascia iliaca block for total hip arthroplasty: A retrospective study
Ya-Li Wang, Yun-Qing Liu, Hua Ni, Xin-Lei Zhang, Li Ding, Fei Tong, Hong-Ye Chen, Xin-Hua Zhang, Ming-Jian Kong
Ya-Li Wang, Yun-Qing Liu, Xin-Lei Zhang, Li Ding, Fei Tong, Hong-Ye Chen, Xin-Hua Zhang, Ming-Jian Kong, Department of Anesthesiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Hua Ni, Rehabilitation Department, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Author contributions: Kong MJ, Wang YL and Liu YQ participated in interpretation of data, drafted and critically revised the manuscript; Kong MJ, Wang YL, Liu YQ and Ni H contributed to study design, interpretation of data, and critically revised the manuscript; Zhang XL, Ding L and Tong F analyzed and assisted in interpretation of the data and assisted in drafting the manuscript; Chen HY and Zhang XH contributed to interpretation of data and critically revised the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of The Second Affiliated Hospital of Xuzhou Medical University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Jian Kong, PhD, Doctor, Department of Anesthesiology, The Second Affiliated Hospital of Xuzhou Medical University, No. 32 Meijian Road, Quanshan District, Xuzhou 221000, Jiangsu Province, China. mjkong@126.com
Received: December 10, 2020
Peer-review started: December 10, 2020
First decision: January 17, 2021
Revised: January 31, 2021
Accepted: March 10, 2021
Article in press: March 10, 2021
Published online: May 26, 2021
Processing time: 140 Days and 0.9 Hours
Abstract
BACKGROUND

Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients undergoing total hip arthroplasty.

AIM

To investigate whether ultrasound-guided, direct suprainguinal injection for fascia iliaca block accelerated recovery after general anesthesia and relieved postoperative pain after total hip arthroplasty.

METHODS

Patients who underwent total hip arthroplasty under general anesthesia in 2015 or 2019 at The Second Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The patients were grouped based on whether preoperative suprainguinal fascia iliaca block was performed or not. The time to tracheal extubation and time spent in the post-anesthesia care unit (PACU), intraoperative remifentanil dosage, fentanyl consumption in the PACU, postoperative cumulative fentanyl consumption within 48 h after operation, visual analogue scale at rest and during movement on the first and second days after surgery, and adverse reactions were compared.

RESULTS

Thirty-one elderly patients who underwent total hip arthroplasty were included in the study (block group, n = 16; no-block group, n = 15). The visual analog scale scores at rest and during movement on the first and second days were significantly lower in the block group than in the no-block group (all P < 0.05). Compared with the no-block group, the intraoperative remifentanil dosage was lower, the time to tracheal extubation and the time spent in the PACU were shorter in the block group (all P < 0.01). Fentanyl consumption in the PACU and postoperative cumulative fentanyl consumption in 48 h after operation were lower in the block group (all P < 0.01). The incidence of dizziness was higher in the no-block group than in the block group (P = 0.037).

CONCLUSION

Ultrasound-guided, direct suprainguinal injection for fascia iliaca block led to faster recovery after general anesthesia and early postoperative pain relief in elderly patients undergoing total hip arthroplasty.

Keywords: Suprainguinal fascia iliaca block; Elderly patients; Total hip arthroplasty; General anesthesia recovery; Postoperative pain

Core Tip: Ultrasound-guided in-plane direct suprainguinal injection for fascia iliaca block is safe, leading to faster recovery after general anesthesia and early relief of postoperative pain in elderly patients undergoing unilateral total hip arthroplasty.