Supra-inguinal fascia iliaca compartment block for postoperative analgesia after Acetabular fracture surgery

Vergari, Alessandro; Frassanito, Luciano; Tamburello, Elio; Nestorini, Roberta; Sala, Filomena Della; Lais, Giulia; Ciolli, Gianluca; Liuzza, Francesco

doi:10.1016/j.injury.2020.10.001

Cited by 9 publications

(18 citation statements)

References 12 publications

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“…Number (%) of the nerves stained with dye following the the suprainguinal fascia iliaca block using 15-50 ml of methylene blue. Vergari et al, 2020). Our result showed the least volume of dye was 40 ml that stained to the LP.…”

Section: Discussionmentioning

confidence: 52%

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Distribution of Various Volumes of Methylene Blue Injection in Suprainguinal Fascia Iliaca Block Under Ultrasound Guidance: A Cadaveric Study

et al. 2022

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The local anesthetic volume for a single-shot suprainguinal fascia iliaca block (SFIB) is a key factor of a block success because the courses of the three target nerves from the lumbar plexus (LP), the lateral femoral cutaneous nerve (LFCN), femoral nerve (FN), and obturator nerve (ON), at the inguinal area are isolated and within striking distance. Thus, this cadaveric study aims to demonstrate the distribution of dye staining on the LFCN, FN, ON, and LP following the ultrasound-guided SFIB using 15-50 ml of methylene blue. A total of 40 USG-SFIBs were performed on 20 fresh adult cadavers using 15, 20, 25, 30, 35, 40, 45, and 50 ml of methylene blue. After the injections, the pelvic and inguinal regions were dissected to directly visualize the dye stained on the LFCN, FN, ON, and LP. All FN and LFCN were stained heavily when the 15-50 ml of dye was injected. Higher volumes of dye (40-50 ml) spread more medially and stained on the ON and LP in 60 % of cases. To increase the possibility of dye spreading to all three target nerves and LP of the SFIB, a high volume (≥40 ml) of anesthetic is recommended. If only a blockade of the FN and LFCN is required, a low volume (15-25 ml) of anesthetic is sufficient.

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Section: Discussionmentioning

confidence: 52%

“…They found that the SFIB spread toward the LP on MRI. This volume was safe and effective for postoperative analgesia after acetabular fracture surgery (Vergari et al, 2020). Moreover, Bravo et al (2020) demonstrated that the SFIB and the LPB provided comparable pain control in total hip arthroplasty.…”

Section: Discussionmentioning

confidence: 95%

Distribution of Various Volumes of Methylene Blue Injection in Suprainguinal Fascia Iliaca Block Under Ultrasound Guidance: A Cadaveric Study

et al. 2022

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“…SIFICB and LPB have been reported to provide perioperative analgesia for patients undergoing acetabular fracture fixation under general anesthesia (GA). [ 3 4 ] However, inadvertent quadriceps weakness or sparing of obturator nerve can happen with SIFICB and LPB, and lateral position is required to perform LPB. The analgesic coverage of both blocks and PENG block is almost similar as they target specific innervation of the anterior capsule of the hip joint.…”

Section: Discussionmentioning

confidence: 99%

“…Various techniques like infiltration of local anesthetic (LA), supra-inguinal fascia iliaca compartment block (SIFICB), and lumbar plexus block (LPB) have been described in the literature as a component of perioperative multimodal analgesia for acetabular surgeries. [ 2 3 4 ] Among the available RA techniques for hip fractures, we believe that the pericapsular nerve group (PENG) block might be suitable for obtaining desired analgesic outcomes for both resting and dynamic pain in acetabular fractures. Although the available literature encourages PENG block for hip fractures involving proximal femur,[ 5 ] there is limited evidence of its application for acetabular fractures.…”

Section: Introductionmentioning

confidence: 99%

Preemptive pericapsular nerve group block to facilitate sitting position for neuraxial anesthesia in patients with acetabular fractures: A case series

et al. 2022

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Acetabular fractures are uncommon types of pelvic fractures associated with restricted mobility due to severe pain. The high analgesic demands can be fulfilled by using multimodal analgesia incorporating regional analgesia. The choice of regional analgesia technique depends on the type of acetabular fracture and innervation of the affected components. We report a case series of five patients with acetabular fractures, in whom pre-emptive administration of pericapsular nerve group block provided effective analgesia to facilitate the sitting position for the neuraxial block.

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“…This procedure with the combination of a specific anesthesiology technique as the supra-inguinal fascia iliaca compartment block has become the standard procedure in our departments for the fracture of the acetabulum that involves the anterior column [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Anterior intrapelvic approach and suprapectineal quadrilateral surface plate for acetabular fractures with anterior involvement: a retrospective study of 34 patients

Ciolli

Mauro

Rovere

et al. 2021

BMC Musculoskelet Disord

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Background The purpose of the study is to evaluate the use of the suprapectineal quadrilateral surface (QLS) plates associated with the anterior intrapelvic approach (AIP) to the acetabulum in the surgical treatment of acetabular fractures with anterior involvement. Methods We did a retrospective study of patients surgically treated with QLS plates and AIP for acetabular fractures with the involvement of the anterior column, between February 2018 and February 2020, in our Hospital. The following data were recorded: mechanism of injury, the pattern of fracture, presence of other associated injuries, the time before performing the surgery, surgical approach, position on operating table, time of surgery, intraoperative bleeding, hospitalization time, intraoperative and postoperative complications. Follow-ups were performed at 1, 3, 6, 12 months, then annually. The clinical-functional outcome was assessed with the Merle d’Aubigne Postel score (MAP) modified by Matta; while the radiological outcome with the Matta Radiological Scoring System (MRSS). A Chi-square test was utilized to examine associations between parametric variables. Results We included 34 patients, mean age 62.1, with an average follow-up of 20.7 months. The most frequent traumatic mechanism was road trauma. There were 15 isolated anterior columns and 19 associated patterns. There were 5 cases of associated visceral injuries, and 10 cases of other associated skeletal fractures. All patients were in the supine position. The surgical approach used was the AIP in all cases, with the addition of the first window of the ilioinguinal approach in 16 cases and of the Kocher-Langenbeck approach in 2 cases. The average time before performing the surgery was 8.5 days. The mean time of the surgery and the mean length of stay after surgery were 227.9 min and 8.2 days, respectively. There weren’t cases of intra-operative complications, while there were postoperative complications in 5 patients. The MRSS was judged anatomical in 26 cases, imperfect in 7 cases and poor in 1 case. The average MAP value was 15.2. We observed a significant relationship between the radiological outcome and the clinical outcome (p < 0.05). Conclusions The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement.

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Supra-inguinal fascia iliaca compartment block for postoperative analgesia after Acetabular fracture surgery

Cited by 9 publications

References 12 publications

Distribution of Various Volumes of Methylene Blue Injection in Suprainguinal Fascia Iliaca Block Under Ultrasound Guidance: A Cadaveric Study

Distribution of Various Volumes of Methylene Blue Injection in Suprainguinal Fascia Iliaca Block Under Ultrasound Guidance: A Cadaveric Study

Preemptive pericapsular nerve group block to facilitate sitting position for neuraxial anesthesia in patients with acetabular fractures: A case series

Anterior intrapelvic approach and suprapectineal quadrilateral surface plate for acetabular fractures with anterior involvement: a retrospective study of 34 patients

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