Fascia Iliaca Compartment Block for Perioperative Pain Management of Geriatric Patients with Hip Fractures: A Systematic Review of Randomized Controlled Trials

Wan, Haoyang; Li, Suyi; Ji, Wei; Yu, Bin; Jiang, Nan

doi:10.1155/2020/8503963

Cited by 21 publications

(23 citation statements)

References 62 publications

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“…[20][21][22] In contrast, adequate pain management has been shown to facilitate postoperative mobilisation, improve mobility and promote better functional recovery. [23][24][25][26] Early mobilisation has been associated with reducing postoperative complications, including pneumonia, venous thromboembolism, pressure ulcers and delirium. [27][28][29] Therefore, optimal perioperative analgesia can facilitate elderly patients' perioperative recovery.…”

Section: Open Accessmentioning

confidence: 99%

Efficacy of pericapsular nerve group (PENG) block on perioperative pain management in elderly patients undergoing hip surgical procedures: a protocol for a systematic review with meta-analysis and trial sequential analysis

Zheng

Chen

et al. 2023

BMJ Open

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IntroductionAn increasing number of elderly patients suffer from hip diseases associated with moderate to severe perioperative pain during the accelerating global ageing process. Optimal analgesia can decrease perioperative complications and facilitate elderly patients’ perioperative recovery. Pericapsular nerve group (PENG) block is a relatively new, analgesia adequate and motor-sparing block technique for perioperative pain management of hip diseases. However, the efficacy of PENG block remains unclear as the limited clinical evidence. Then, we will perform a protocol for a systematic review and meta-analysis to identify the efficacy of PENG block for perioperative pain management.Methods and analysisPubMed, Ovid Medline, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Chinese BioMedical Literature, Wanfang and VIP databases will be searched from inception to August 2022 to identify randomised controlled trials of elderly patients accepting PENG block for hip diseases. The primary outcome will be the pain intensity after pain management. Secondary outcomes will be quadriceps strength, perioperative rescue analgesia information and perioperative complications. Assessment of heterogeneity will be primarily inspected by forest plots. If there is no indication of funnel plot asymmetry, a random-effects meta-analysis will be performed. The Cochrane risk-of-bias tool, Grading of Recommendations Assessment, Development and Evaluation and trial sequential analysis will be conducted to evaluate the evidence quality and control the random errors. Funnel plots and Egger’s regression test will be performed to evaluate publication bias.Ethics and disseminationEthical approval was not required for this systematic review protocol. The results will be disseminated through peer-reviewed publications.PROSPERO registration numberCRD42022313895

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Section: Open Accessmentioning

confidence: 99%

Efficacy of pericapsular nerve group (PENG) block on perioperative pain management in elderly patients undergoing hip surgical procedures: a protocol for a systematic review with meta-analysis and trial sequential analysis

Zheng

Chen

et al. 2023

BMJ Open

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“…As expected, preoperative regional analgesia provided significantly better pain relief to systemic analgesia alone, especially when dealing with pain on movement. [26][27][28][29] .…”

Section: Pain Reliefmentioning

confidence: 99%

Peripheral Nerve Blocks for Hip Fractures in Emergency Medicine

Simić

Adam

Rošić

et al. 2022

ACC

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Hip fractures represent a major public health issue with increasing incidence as a population ages. The aim of this review is to describe peripheral nerve block techniques (the fascia iliaca compartment block and the pericapsular nerve group block) as pain management for hip fractures in emergency medicine, and to emphasize their benefits. Hip fractures are extremely painful injuries. The pain itself is unpleasant for patients and if left untreated it can lead to multiple complications during preoperative, operative and postoperative patient management. Pain management for elderly hip fracture patients is often challenging. Non-steroidal anti-inflammatory drugs are not recommended due to their side effects, the increased risk of gastrointestinal bleeding, renal function impairment and platelet aggregation inhibition. Paracetamol alone is often insufficient, and opioids have many potentially harmful side effects, such as delirium development. Peripheral nerve blocks for hip fractures are safe and effective, also in emergency medicine settings. The benefits for patients are greater pain relief, especially during movement, less opioid requirements and decreased incidence of delirium. Regional analgesia should be routinely used in hip fracture pain management.

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“…However, different volumes of LA were used in those studies and naturally different analgesia duration and opioid consumption were reported. [4,5] To the best of our knowledge, there are limited reports focusing on LA volume. [6,7] Our aim in this study was to find the most clinically effective volume by comparing three different volumes of bupivacaine used frequently in the literature for US-guided infra-inguinal FICB for post-operative pain control in patients undergoing femur and knee surgery.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5] 3[1][2][3][4][5] 2[1][2][3] 0.620Values are given as Median (Minimum-Maximum) * p<005. VAS: Visual Analog Scale.…”

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confidence: 99%

A comparison of different volumes of bupivacaine used in fascia iliaca compartment block introduction

Gül

Kılınç

Şahin

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Fascia iliaca compartment block (FICB) is one of the regional techniques applied for post-operative pain control after femoral and knee surgery. To the best of our knowledge, there are limited reports focusing on local anesthetic (LA) volume. Our aim in this study was to find the most clinically effective volume by comparing three different volumes of LA used frequently in the literature for US-guided infra-inguinal FICB for post-operative pain control in patients undergoing femur and knee surgery. METHODS:A total of 45 patients with ASA I-III physical scores were included in the study. When the surgical procedure was completed under general anesthesia, FIKB was applied with 0.25% Bupivacaine under ultrasound guidance to the patients before extubation. Patients were randomly divided into three different groups for the volume of local anesthetic to be administered. Bupivacaine was administered 0.3 mL/kg in Group 1, 0.4 mL/kg in Group 2 and 0.5 mL/kg in Group 3. After FIKB, the patients were extubated. The patients were followed up for 24 h postoperatively in terms of vital signs, pain scores, additional analgesic requirement, and possible side effects. RESULTS:When the post-operative pain scores were compared, the scores of Group 1 were found to be statistically higher than Group 3 at the post-operative 1 st , 4 th , and 6 th h (p<0.05). When the additional analgesia requirement compared, the post-operative 4 th h was highest in Group 1 compared to the other groups (p=0.03). At the post-operative 6th h, additional analgesic requirement was less in Group 3 than in the other groups, and there was no difference between Groups 1 and 2 (p=0.026). As the LA volume increased, the amount of analgesic consumed in the first 24 h decreased, but there was no statistically significant difference (p=0.051). CONCLUSION:Our study showed that ultrasound-guided FIKB is a safe and effective method for post-operative pain relief as a part of multimodal analgesic components, and 0.25% bupivacaine in 0.5 mL/kg volume provides more effective analgesia than the other two groups without any side effects.

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Fascia Iliaca Compartment Block for Perioperative Pain Management of Geriatric Patients with Hip Fractures: A Systematic Review of Randomized Controlled Trials

Cited by 21 publications

References 62 publications

Efficacy of pericapsular nerve group (PENG) block on perioperative pain management in elderly patients undergoing hip surgical procedures: a protocol for a systematic review with meta-analysis and trial sequential analysis

Efficacy of pericapsular nerve group (PENG) block on perioperative pain management in elderly patients undergoing hip surgical procedures: a protocol for a systematic review with meta-analysis and trial sequential analysis

Peripheral Nerve Blocks for Hip Fractures in Emergency Medicine

A comparison of different volumes of bupivacaine used in fascia iliaca compartment block introduction

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