Dataset Information

Evaluation of Postoperative Analgesic Efficacy of Ultrasound-Guided Suprainguinal Fascia Iliaca Block in Knee Arthroplasty: Prospective, Randomized, Feasibility Study.

ABSTRACT:

Background

Total Knee Arthroplasty (TKA) is one of the most commonly performed orthopedic procedures, and patients complain of severe pain in the postoperative period. The supra-inguinal fascia iliaca block (SIFIB) works as an anteriorly applied lumbar plexus block and is frequently used in hip surgeries. In this study, we evaluated the effect of SIFIB in patients undergoing TKA under spinal anesthesia.

Methods

This study is a prospective, randomized, assessor-blinded feasibility study conducted in a tertiary hospital. Eighty-six patients with ASA I-III were initially enrolled, and after exclusions, 80 patients were randomized into two equal groups (SIFIB and control groups). The standard multimodal analgesia was applied to the control group, while SIFIB was additionally applied to the block group. The study measured the morphine requirement in PCA and pain intensity using Numeric Rating Scores between the two groups.

Results

the 24-h cumulative morphine consumption was lower in Group SIFIB. Although there was a decrease in NRS at rest scores in the SIFIB group during some time periods, pain was moderate, and no differences in pain scores were recorded during exercise in all patients.

Conclusions

In patients undergoing TKA under spinal anesthesia, a single shot of SIFIB results in a significant reduction in the amount of morphine consumed in hours. This effect was most likely related to a decrease in pain at rest in the SIFIF group.

SUBMITTER: Kefeli Celik H

PROVIDER: S-EPMC10531897 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Evaluation of Postoperative Analgesic Efficacy of Ultrasound-Guided Suprainguinal Fascia Iliaca Block in Knee Arthroplasty: Prospective, Randomized, Feasibility Study.

Kefeli Çelik Hale H Tulgar Serkan S Güler Serkan S Koç Kadem K Küçükordulu Büşra Burcu BB Ferli Ramazan Burak RB Kehribar Lokman L Genç Ahmet Serhat AS Süren Mustafa M

Journal of clinical medicine 20230920 18

<h4>Background</h4>Total Knee Arthroplasty (TKA) is one of the most commonly performed orthopedic procedures, and patients complain of severe pain in the postoperative period. The supra-inguinal fascia iliaca block (SIFIB) works as an anteriorly applied lumbar plexus block and is frequently used in hip surgeries. In this study, we evaluated the effect of SIFIB in patients undergoing TKA under spinal anesthesia.<h4>Methods</h4>This study is a prospective, randomized, assessor-blinded feasibility ...[more]

PMID: 37763016

Similar Datasets

Project description:Study objective The ultrasound-guided (US-guided) suprainguinal fascia iliaca block (SIFIB) is a regional anesthesia procedure that targets the lumbar plexus. It offers versatility in clinical practice, serving as both a standalone method for adequate pain management and a primary anesthesia option. Our aim was to present clinical insights gained from the application of US-guided SIFIB, whether as a standalone procedure or in conjunction with another block, across various clinical indications for lower extremity surgeries. Methodology Our study is a retrospective cohort analysis designed to identify cases in which the SIFIB was used as a component of the main anesthetic method and to determine the success of the anesthetic method in patients undergoing lower extremity surgery between March 2022 and March 2023 in a tertiary hospital. Data such as block success, perioperative additional analgesic need, patients' demographic details, and block characteristics were obtained from electronic and paper-based patient records and analyzed. Main results We analyzed data from 16 patients who underwent lower extremity surgeries under SIFIB. Among these, 10 patients received SIFIB as their sole anesthesia method, while six underwent surgery with a combination of sciatic block and SIFIB. Briefly, the types of surgery were amputations, soft tissue excision, revision of knee prostheses, excision of knee tumors, patella implant removal, patellar ligament repair, patellar fracture repair, distal femur fractures (internal fixation), and vascular surgery. Six patients necessitated additional analgesics. No statistically significant differences were observed in demographic details, block onset time, and surgical duration between patients requiring and not requiring sedoanalgesia during surgery (p>0.05). Conclusion For patients planning lower extremity surgery, considering SIFIB alone or combined with a sciatic block as part of anesthesia management is a valid option, offering an alternative to a lumbar plexus block.

Project description:BackgroundHip replacement surgery is increasingly common due to an ageing population, and rising levels of obesity. The provision of excellent pain relief with minimal side effects is important in order to facilitate patient mobilisation and rehabilitation.Spinal opioids provide excellent analgesia but are associated with adverse effects. The fascia-iliaca block is an alternative technique which provides analgesia to the nerves innervating the hip. The success of fascia iliaca blocks has been demonstrated to be superior when using ultrasound compared to landmark techniques. However, the clinical benefit of this improvement has yet to be investigated.The aim of this study is to compare the efficacy and safety of ultrasound guided fascia iliaca block with spinal morphine for hip replacement surgery.Methods/designThis study is a randomised, blinded, placebo-controlled, noninferiority trial. Patients scheduled to undergo unilateral primary hip arthroplasty will receive a study information sheet and consent will be obtained in keeping with the Declaration of Helsinki. Patients will be randomised to receive either; (i) Ultrasound guided fascia iliaca block using levobupivacaine, plus spinal anaesthesia with hyperbaric bupivacaine containing no morphine, or (ii) sham ultrasound guided fascia iliaca block performed with sterile saline, and spinal anaesthesia containing hyperbaric bupivacaine and 0.1 mg of spinal morphine.A total of 108 patients will be recruited. Primary outcome is post-operative morphine consumption in a 24 hour period. Secondary outcomes include; pain scores at 3, 6, 12, 24, 36 and 48 hours, episodes of respiratory depression, hypotension, nausea and vomiting, pruritus, sedation, time to first mobilisation and patient satisfaction.ConclusionsThere are no studies to date comparing ultrasound guided fascia iliaca block with spinal morphine for pain control after hip arthroplasty. If the ultrasound guided fascia iliaca block provides pain relief which is not inferior to spinal morphine, then morphine could be removed from the spinal injection. This could reduce side effects and improve patient safety.Trial registrationThis study has been approved by the West of Scotland Research Ethics Committee 4 (reference no. 10/S0704/43) and is registered with ClinicalTrials.gov (reference no. NCT01217294).

Dataset Information

Evaluation of Postoperative Analgesic Efficacy of Ultrasound-Guided Suprainguinal Fascia Iliaca Block in Knee Arthroplasty: Prospective, Randomized, Feasibility Study.

Background

Methods

Results

Conclusions

Publications

Evaluation of Postoperative Analgesic Efficacy of Ultrasound-Guided Suprainguinal Fascia Iliaca Block in Knee Arthroplasty: Prospective, Randomized, Feasibility Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets