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The aim of our study was to evaluate the efficacy and patient satisfaction level of SI-FIB and lumbar ESPB for positioning and postoperative analgesia during spinal anesthesia in patients undergoing hip fracture surgery.
Hip fractures, which are one of the leading causes of mortality and morbidity with increasing age, are common and usually require surgery and cause severe pain in the perioperative period, which may result in delirium, sleep disturbances and chronic pain. This pain can be managed using neuraxial and regional techniques, as well as pharmacologic agents such as nonsteroidal analgesics, opioids and gabapentinoids, and interventions such as periarticular injections and peripheral nerve blocks. Supra-inguinal fascia iliaca block (SI-FIB) is a technique that blocks all components of the lumbar plexus, including the femoral nerve, latero-femoral nerve and obturator nerve. It is thought to function in a similar way to the anterior lumbar plexus block. Studies have successfully demonstrated the effectiveness of SIFIB in reducing postoperative pain after hip surgery. The lumbar erector spina plan block (ESPB) has been described for use in hip and femur surgery and radiologic evaluation and clinical results have shown that it provides similar analgesia to the lumbar plexus block at high volumes. It is accepted that multimodal analgesia is the best option for pain control and peripheral nerve blocks are effectively applied for this purpose. In this way, opioid use and related side effects such as nausea, vomiting, pruritus and sedation are reduced, and early mobilization, reduced hospital stay and prevention of postoperative complications are also contributed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Grup-S | Patients were divided into 3 groups and grouped as Group-S with suprainguinal fascia iliaca block, Group-L with lumbar erector spina plan block and Group-C as control group. For postoperative analgesia, preoperative midazolam premedication and USG-guided suprainguinal fascia iliaca plan block with 20 ml of 0.25% Bupivacaine was planned to be performed in Group-S and lumbar erector spina plan block was planned to be performed at the L3-4 level in Group-L. | ||
| Grup-L | Patients were divided into 3 groups and grouped as Group-S with suprainguinal fascia iliaca block, Group-L with lumbar erector spina plan block and Group-C as control group. For postoperative analgesia, preoperative midazolam premedication and USG-guided suprainguinal fascia iliaca plan block with 20 ml of 0.25% Bupivacaine was planned to be performed in Group-S and lumbar erector spina plan block was planned to be performed at the L3-4 level in Group-L. | ||
| Grup-C | Patients were divided into 3 groups and grouped as Group-S with suprainguinal fascia iliaca block, Group-L with lumbar erector spina plan block and Group-C as control group. For postoperative analgesia, preoperative midazolam premedication and USG-guided suprainguinal fascia iliaca plan block with 20 ml of 0.25% Bupivacaine was planned to be performed in Group-S and lumbar erector spina plan block was planned to be performed at the L3-4 level in Group-L. |
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| Measure | Description | Time Frame |
|---|---|---|
| Assessment of pain during spinal anesthesia position | The primary objective of our study is to compare the effectiveness of SI-FIB and lumbar ESPB in patients undergoing hip fracture surgery by evaluating NRS scores during positioning for spinal anesthesia. | The NRS score will be recorded before the block. The NRS score will be recorded 20 minutes after the block is administered. The NRS score will be recorded when the patient is placed in a sitting position for spinal anesthesia. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Pain Intensity at Rest and During Activity | Postoperative pain intensity at rest and during activity will be assessed using the Numeric Rating Scale. The Numeric Rating Scale ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse pain. Unit of Measure: Numeric Rating Scale score | 0, 2, 6, 12, and 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Complications | Postoperative complications will be recorded during the postoperative follow-up period. | From the end of surgery to 48 hours |
| Time to First Mobilization | Time to first mobilization will be recorded as the time from the end of surgery to the first postoperative mobilization. |
Inclusion Criteria:
Exclusion Criteria:
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Patients who underwent surgery with spinal anesthesia due to hip fracture at Sancaktepe Şehit Prof. Dr. İlhan Varank Education and Research Hospital of Health Sciences University and were treated with suprainguinal plane block and lumbar rectus fascia plane block for postoperative analgesia will be examined in the study, along with patients who did not receive the block.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital | Istanbul | Sancaktepe | 34785 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21401544 | Background | Hebbard P, Ivanusic J, Sha S. Ultrasound-guided supra-inguinal fascia iliaca block: a cadaveric evaluation of a novel approach. Anaesthesia. 2011 Apr;66(4):300-5. doi: 10.1111/j.1365-2044.2011.06628.x. Epub 2011 Feb 24. | |
| 28059869 | Background | Desmet M, Vermeylen K, Van Herreweghe I, Carlier L, Soetens F, Lambrecht S, Croes K, Pottel H, Van de Velde M. A Longitudinal Supra-Inguinal Fascia Iliaca Compartment Block Reduces Morphine Consumption After Total Hip Arthroplasty. Reg Anesth Pain Med. 2017 May/Jun;42(3):327-333. doi: 10.1097/AAP.0000000000000543. |
| Label | URL |
|---|---|
| Related Info | View source |
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I do not plan to share IPD for data security reasons.
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| Additional Analgesic Consumption | Additional analgesic consumption will be recorded as the total amount of rescue analgesic administered postoperatively. | From the end of surgery to 24 hours postoperatively |
| Patient Satisfaction With Postoperative Analgesia | Patient satisfaction with postoperative analgesia will be assessed using a 4-point satisfaction scale. The scale ranges from 1 to 4, where 1 indicates very satisfied, 2 indicates satisfied, 3 indicates undecided, and 4 indicates not satisfied. Higher scores indicate lower satisfaction. | 24 hours postoperatively |
| Perioperative/Periprocedural |
| Length of Hospital Stay | Length of hospital stay will be recorded as the time from surgery to hospital discharge. | Perioperative/Periprocedural |
| 29030933 | Background | Eastburn E, Hernandez MA, Boretsky K. Technical success of the ultrasound-guided supra-inguinal fascia iliaca compartment block in older children and adolescents for hip arthroscopy. Paediatr Anaesth. 2017 Nov;27(11):1120-1124. doi: 10.1111/pan.13227. |
| 27022583 | Background | Alves WM Jr, Migon EZ, Zabeu JL. PAIN FOLLOWING TOTAL KNEE ARTHROPLASTY - A SYSTEMATIC APPROACH. Rev Bras Ortop. 2015 Dec 12;45(5):384-91. doi: 10.1016/S2255-4971(15)30424-9. eCollection 2010 Sep-Oct. |
| ID | Term |
|---|---|
| D006620 | Hip Fractures |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D005264 | Femoral Fractures |
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D025981 | Hip Injuries |
| D007869 | Leg Injuries |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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