Effectiveness of Ultrasound-guided Single-injection Triple Nerve Block Before Cementless Bipolar Hip Hemiarthroplasty in Femoral Neck Fractures
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Purpose: To compare efficacy of ultrasound (US)-guided single-injection nerve blocks (SINB) before bipolar hemiarthroplasty (BHA) of the hip in patients with femoral neck fractures. Materials and Methods: Clinical outcomes of 89 patients who underwent BHA between September 2016 and February 2018 were retrospectively compared. Eight patients were excluded according to exclusion criteria and the remaining patients were divided into two groups: patients who received SINB before surgery (Group I; n=40), and patients who did not (Group II; n=41). The femoral, obturator, and lateral femoral cutaneous nerves were each blocked separately under US guidance. Pain scores determined using the visual analogue scale (VAS) were recorded 6, 12, 24, and 48 hours postoperatively, and all use of analgesics were recorded separately for 72 hours after surgery. Duration of hospitalization, general complications, and local complications due to SINB were also compared among the groups. Results: Significant differences were observed between the two groups: I) VAS at 6 hours and at 12 hours after the operation, II) total amounts of analgesics used. VAS at 24 hours and at 48 hours were not significantly different between the two groups. General complications and duration of hospitalization were also not significantly different between the groups. Conclusion: US-guided lower limb nerve blocks provide excellent immediate postoperative pain relief and can be used as a safe, and effective method of pain control after BHA.
Abstract
Purpose: To compare efficacy of ultrasound (US)-guided single-injection nerve blocks (SINB) before bipolar hemiarthroplasty (BHA) of the hip in patients with femoral neck fractures. Materials and Methods: Clinical outcomes of 89 patients who underwent BHA between September 2016 and February 2018 were retrospectively compared. Eight patients were excluded according to exclusion criteria and the remaining patients were divided into two groups: patients who received SINB before surgery (Group I; n=40), and patients who did not (Group II; n=41). The femoral, obturator, and lateral femoral cutaneous nerves were each blocked separately under US guidance. Pain scores determined using the visual analogue scale (VAS) were recorded 6, 12, 24, and 48 hours postoperatively, and all use of analgesics were recorded separately for 72 hours after surgery. Duration of hospitalization, general complications, and local complications due to SINB were also compared among the groups. Results: Significant differences were observed between the two groups: I) VAS at 6 hours and at 12 hours after the operation, II) total amounts of analgesics used. VAS at 24 hours and at 48 hours were not significantly different between the two groups. General complications and duration of hospitalization were also not significantly different between the groups. Conclusion: US-guided lower limb nerve blocks provide excellent immediate postoperative pain relief and can be used as a safe, and effective method of pain control after BHA.
참고문헌 (15)
- Morrison RS, "Relationship between pain and opioid analgesics on the development of delirium following hip fracture", J Gerontol A Biol Sci Med Sci, 58, pp.76~81 (2003)
- Morrison RS, "A comparison of pain and its treatment in advanced dementia and cognitively intact patients with hip fracture", J Pain Symptom Manage, 19, pp.240~248 (2000)
- Kelley AS, "Pitfalls and recommendations regarding the management of acute pain among hospitalized patients with dementia", Pain Med, 9, pp.581~586 (2008)
- Joshi GP, "Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain", Anesthesiol Clin North Am, 23, pp.21~36 (2005)
- 김성곤, "고령환자에서 양극성 반치환술에 의한 대퇴 경부골절의 치료 후 사망률 및 기능회복에 대한 분석", Hip and Pelvis, 14(1), pp.49~55 (2002), 대한고관절학회
- Chang JD, "A study of the factors which influence on the one-year mortality rate after hemiarthroplasty in older patients with hip fracture", J Korean Hip Soc, 10, pp.225~232 (1998)
- Christie IW, "Major complications of epidural analgesia after surgery : results of a six-year survey", Anaesthesia, 62, pp.335~341 (2007)
- Kang H, "Effectiveness of multimodal pain management after bipolar hemiarthroplasty for hip fracture : a randomized, controlled study", J Bone Joint Surg Am, 95, pp.291~296 (2013)
- Beaudoin FL, "A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures : a randomized controlled trial", Acad Emerg Med, 20, pp.584~591 (2013)
- Guay J, "Nerve blocks or no nerve blocks for pain control after elective hip replacement (arthroplasty)surgery in adults", Cochrane Database Syst Rev, 10, pp.CD011608~ (2017)
- Winnie AP, "The inguinal paravascular technic of lumbar plexus anesthesia : the"3-in-1 block"", Anesth Analg, 52, pp.989~996 (1973)
- Tomonori Tetsunaga, "Comparison of Continuous Epidural Analgesia, Patient-Controlled Analgesia with Morphine, and Continuous Three-in-One Femoral Nerve Block on Postoperative Outcomes after Total Hip Arthroplasty", Clinics in Orthopedic Surgery, 7(2), pp.1~7 (2015), 대한정형외과학회
- Geier KO, "Anterior ‘3-in-1’ blockade: partial, total or overdimensioned block? Correlation between anatomy, clinic and radio images", Rev Bras Anestesiol, 54, pp.560~572 (2004)
- Lang SA, "The femoral 3-in-1 block revisited", J Clin Anesth, 5, pp.292~296 (1993)
- Kooger Infante NE, "Extent of hyperbaric spinal anesthesia influences the duration of spinal block", Anesthesiology, 92, pp.1319~1323 (2000)
