Bloc iliofascial et troubles cognitifs postopératoires chez la personne âgée

Perrier, Virginie; Julliac, B.; Lelias, A.; Morel, Nicolas; Dabadie, P.; Sztark, F.

doi:10.1016/j.annfar.2009.12.021

Cited by 17 publications

(2 citation statements)

References 28 publications

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“…The Aβ levels of the patients in group C were significantly higher than those in group E on postoperative day 3 (P < 0.05). This indicates that ultrasoundguided iliac fascia gap block may be beneficial in improving cognitive function scores and reducing the occurrence of postoperative cognitive function in elderly patients undergoing hip surgery, mainly by reducing post-operative pain and controlling the levels of Aβ and tau (Perrier et al, 2010;Ji et al, 2013).…”

Section: E Ect Of Nerve Block On Mmse Aβ and Tau Contentmentioning

confidence: 96%

Fascia iliaca compartment block can reduce the incidence of early post-operative cognitive impairment in elderly patients with high-risk hip replacement

Guo

et al. 2022

Front. Aging Neurosci.

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ObjectiveIn this study, we aimed to observe the effects of ultrasound-guided fascia iliaca compartment block (FICB) combined with hypobaric spinal anesthesia on post-operative pain and cognitive function in elderly patients with high-risk hip replacement.MethodsA total of 84 elderly patients—aged 65–85 years, with American Society of Anesthesiologists physical status III–IV, and scheduled for hip arthroplasty between September 2021 and May 2022—were selected. One or more organs with moderate to severe impairment were included in all patients. The patients were randomly divided into a hypobaric spinal anesthesia group (group C, control group) and an ultrasound-guided FICB combined with hypobaric spinal anesthesia group (group E, experimental group). Group C was given 3.5 mL of 0.32% ropivacaine hypobaric spinal anesthesia, and group E received ultrasound-guided FICB combined with 3.5 mL of 0.32% ropivacaine hypobaric spinal anesthesia. The patients were compared using the visual analog scale (VAS) for pain, Harris hip function score, and simple Mini-Mental State Examination (MMSE) scale. Blood β-amyloid (Aβ) and neuronal microtubule-associated protein (tau) levels were measured. We compared intraoperative conditions and post-operative complications between the two groups to assess the effects of FICB combined with hypobaric spinal anesthesia on post-operative pain and cognitive function in elderly patients with high-risk hip replacement.ResultsAt 1 and 3 days after the operation, patients in group C had significantly higher VAS and lower MMES scores than those in group E. The differences were statistically significant at 1 (P < 0.01) and 3 (P < 0.05) days after the operation. At 1 day after operation, the Harris score of patients in group C was significantly lower than that of patients in group E (P < 0.05). The Aβ and tau levels of patients in group C were significantly higher than those of patients in group E at 1 day after the operation (P < 0.01). The Aβ levels of patients in group C were significantly higher than those of patients in group E at 3 days after the operation (P < 0.05). The intraoperative conditions and post-operative complication rates did not differ significantly between the two groups. At 1 day before and 5 days after the operation, there was no difference in any of the indicators.ConclusionBy lowering pain and managing Aβ and tau protein concentrations, FICB can successfully lower the incidence of early post-operative cognitive impairment in elderly patients with high-risk hip replacement.Clinical trial registrationwww.chictr.org.cn, identifier: ChiCTR2100051162.

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Section: E Ect Of Nerve Block On Mmse Aβ and Tau Contentmentioning

confidence: 96%

Fascia iliaca compartment block can reduce the incidence of early post-operative cognitive impairment in elderly patients with high-risk hip replacement

Guo

et al. 2022

Front. Aging Neurosci.

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“…If the data were described as median (interquartile range), we estimated the mean and standard deviation using the equation presented by Wan et al [ 22 ]. To determine the frequency of POD occurrence, when the cognitive state was described by continuous variables, we contacted the authors [ 23 , 24 , 25 ], requesting data on the number of patients with POD occurrence; however, none of them replied.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Peripheral Nerve Block on Postoperative Delirium in Older Adults Undergoing Hip Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Kim

et al. 2023

JCM

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This meta-analysis aimed to determine whether peripheral nerve blocks (PNB) reduce postoperative delirium (POD) in elderly patients undergoing hip surgery. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022328320). The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for randomized controlled trials (RCTs) on 26 April 2022. A total of 19 RCTs with 1977 participants were included. Perioperative PNB lowered the POD incidence on the third postoperative day (OR: 0.59, 95% CI [0.40 to 0.87], p = 0.007, I2 = 35%), in patients without underlying cognitive impairment (OR: 0.47, 95% CI [0.30 to 0.74], p = 0.001, I2 = 30%), and when a fascia iliaca compartment block (OR: 0.58, 95% CI [0.37 to 0.91], p = 0.02, I2 = 0%) or a femoral nerve block (OR: 0.33, 95% CI [0.11 to 0.99], p = 0.05, I2 = 66%) were performed. The pain score was also reduced (SMD: −0.83, 95% CI [−1.36 to −0.30], p = 0.002, I2 = 95%) after PNB. Perioperative PNB can lower the POD incidence and pain scores up to the third postoperative day. However, considering the wide variety of PNBs performed, more trials are needed to identify the effects of each PNB on POD.

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Peripheral nerve blocks for hip fractures in adults

Guay

Kopp

2020

Cochrane Database of Systematic Reviews

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Bloc iliofascial et troubles cognitifs postopératoires chez la personne âgée

Cited by 17 publications

References 28 publications

Fascia iliaca compartment block can reduce the incidence of early post-operative cognitive impairment in elderly patients with high-risk hip replacement

Fascia iliaca compartment block can reduce the incidence of early post-operative cognitive impairment in elderly patients with high-risk hip replacement

The Effect of Peripheral Nerve Block on Postoperative Delirium in Older Adults Undergoing Hip Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Peripheral nerve blocks for hip fractures in adults

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