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This study evaluates the effectiveness of postoperative analgesia quality, Interleukin-6, Hemodynamic stability and QoR-40 of continuous Suprainguinal Fascia Iliaca Compartment Block (S-FICB) compared with continuous epidural in patients undergoing cephalomedullary nailing surgery.
Half of participants will receive continuous S-FICB with patient control regional analgesia using ropivacaine 0.2% continue 2ml/hr and demand dose 5ml as needed, while the other half will receive continuous epidural with patient control epidural analgesia using same regimen.
The Continuous Suprainguinal Fascia Iliaca Compartment Block (S-FICB) and continuous epidural are regional anaesthesia that can be used to relieve postoperative pain of femur surgery. But there are few studies have been done to compare both techniques.
The S-FICB is an alternate peripheral nerve block technique using local anaesthetic administered into the fascia iliaca compartment at the inguinal region which targets the femoral, obturator and lateral femoral cutaneous nerves.
The epidural is well known and proven to have an adequate analgesia effect using local anaesthetic in the epidural region targeted for femur surgery.
Based on previous studies, the effectiveness of the S-FICB single shot was no longer than 18 hours. Then we choose to continue S-FICB to find out how adequate it is. The S-FICB with ropivacaine has a proven anti-inflammatory effect for the first 24 hours postoperative.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment S-FICB Arm | Experimental | S-FICB with PCRA using Ropivacaine 0.2% continuous 2ml/hr, demand dose 5ml as needed. |
|
| Treatment Epidural Arm | Experimental | Epidural with PCEA using Ropivacaine 0.2% continuous 2ml/hr, demand dose 5ml as needed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Continuous Suprainguinal Fascia Iliaca Compartment Block | Other | Using PCRA and Local Anesthetic Ropivacaine 0.2% continuous 2ml/hr and demand dose 5ml as needed. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The Quality of Postoperative Analgesia | Assess the local anesthetic dosage in milligrams from patient controlled analgesia Machine for attempt dose, delivered dose and 24 hours total doses. | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Delta Interleukin-6 | Laboratory report for interleukin-6 preoperative and 24 hours posoperative then calculate the delta Interleukin-6 | 3 days |
| Hemodynamic Stability | Monitoring blood pressure category as stable or not stable. Stable if systolic blood pressure is above 100 mmHg. Not Stable if systolic blood pressure is under 100 mmHg. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tjokorda Gde Agung Senapathi | Udayana University | Principal Investigator |
| I Gusti Ngurah Mahaalit Aribawa | Udayana University | Principal Investigator |
| I Gusti Agung Gede Utara Hartawan | Udayana University | Principal Investigator |
| I Gede Budiartha | Udayana University | Principal Investigator |
| I Made Gede Widnyana | Udayana University | Principal Investigator |
| Made Agus Kresna Sucandra | Udayana University | Study Chair |
| Ida Bagus Krisna Jaya Sutawan | Udayana University | Study Chair |
| I Putu Pramana Suarjaya | Udayana University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Prof IGNG Ngoerah Hospitals | Denpasar | Bali | 80113 | Indonesia | ||
| Udayana University |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | El Sherbeny, S., Maguid, H., El Dourgham, L., Ibrahim, O., Patient Controlled Analgesia: Fascia Iliaca Compartment Block Versus Epidural Analgesia for Postoperative Pain Relief Following Total Knee Replacement Under Spinal Anesthesia: A Comparative Study. Zagazig University Medical Journal, 2022; (318-325): -.doi: 10.21608/zumj.2020.28085.1821 | ||
| 34324929 | Background | Azizoglu M, Rumeli S. Comparison of the suprainguinal fascia iliaca compartment block with continuous epidural analgesia in patients undergoing hip surgeries: a retrospective study. Braz J Anesthesiol. 2022 May-Jun;72(3):342-349. doi: 10.1016/j.bjane.2021.07.006. Epub 2021 Jul 26. | |
| 35620203 |
| Label | URL |
|---|---|
| The World Federation of Societies of Anaesthesiologists have updated information about Fascia Iliaca Compartment Block | View source |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| Continuous Epidural | Other | Using PCEA and Local Anesthetic Ropivacaine 0.2% continuous 2ml/hr and demand dose 5ml as needed. |
|
| 24 hours |
| Questionnaire of Recovery 40 (QoR-40) | Assess the subject recovery condition using questionnaires QoR-40. The score range from 40 (extremely poor quality of recovery) to 200 (excellent quality of recovery). | 24 hours |
| Denpasar |
| Bali |
| 80234 |
| Indonesia |
| Background |
| Zhu K, Zheng F, Wang C, Ding L. Effect of Ultrasound-Guided Fascia Iliac Compartment Block on Serum NLRP3 and Inflammatory Factors in Patients with Femoral Intertrochanteric Fracture. Comput Math Methods Med. 2022 May 17;2022:1944659. doi: 10.1155/2022/1944659. eCollection 2022. |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |