Background. With continuous increase of the aging population, the number of geriatric patients with fragility hip fractures is rising sharply, and timely surgery remains the mainstay of treatment. However, adequate and effective pain control is the precondition of satisfactory efficacy. This systematic review aimed to summarize the use of fascia iliaca compartment block (FICB) as an analgesic strategy for perioperative pain management in geriatric patients with hip fractures. Methods. PubMed and Embase databases were searched for English published randomized controlled trials (RCTs) reporting application of FICB for pain control of the older adults with hip fractures between January 1^st, 2000, and May 31^st, 2020. The modified Jadad scale was used to evaluate quality of the RCTs included. Primary outcomes of the eligible RCTs were presented and discussed. Results. A total of 27 RCTs with 2478 cases were included finally. The present outcomes suggested, after admission or in the emergency department (ED), FICB can provide patients with equal or even better pain relief compared with the conventional analgesia methods, which can also reduce additional analgesic consumptions. While, before positioning for spinal anesthesia (SA), FICB is able to offer superior pain control, facilitating SA performance, after surgery FICB can effectively alleviate pain with decreased use of additional analgesics, promoting earlier mobilization and preventing complications. Conclusions. FICB is a safe, reliable, and easy-to-conduct technique, which is able to provide adequate pain relief during perioperative management of geriatric patients with hip fractures.

中文翻译：

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筋膜Iliaca隔离块用于老年患者髋部骨折的围手术期疼痛管理：随机对照试验的系统评价

背景。随着人口老龄化的不断增加，老年脆性髋部骨折患者数量急剧增加，及时手术仍是治疗的主要手段。但是，充分有效的止痛是取得满意疗效的前提。该系统评价旨在总结ilia骨筋膜室阻滞（FICB）作为老年髋部骨折患者围手术期疼痛控制的镇痛策略。方法。搜索PubMed和Embase数据库以查找英文发表的随机对照试验（RCT），该试验报告了FICB在2000年1月1^日至5月31^日之间的老年人髋部骨折疼痛控制中的应用，2020年。经修改的Jadad量表用于评估所含RCT的质量。提出并讨论了符合条件的RCT的主要结局。结果。最终纳入了27个RCT，共2478例。目前的结果表明，入院后或在急诊室（ED），与传统的止痛方法相比，FICB可以为患者提供相同甚至更好的止痛效果，这也可以减少额外的止痛药消耗。FICB能够在定位脊髓麻醉（SA）之前提供出色的疼痛控制，促进SA的表现，而手术后FICB可以有效减少疼痛，减少使用额外的镇痛药，促进早期动员并预防并发症。结论。FICB是一种安全，可靠且易于实施的技术，能够在老年髋部骨折患者的围手术期管理期间提供足够的疼痛缓解。