Purpose

Pain management is a challenging issue in elderly patients with hip fracture. Despite the accepted clinical outcomes following hip surgery, pain and prolonged recovery time are the most difficult consequences associated with the rehabilitation process. The purpose of this study was to evaluate pain relief and functional improvement associated with the Fascia Iliaca Compartment Block (FICB) during the perioperative period of elderly patients with hip fracture.

Patients and methods

This study included 120 elderly patients with hip fracture, who were admitted to our institution between January 2019 and December 2020. The participants were subsequently randomly divided into the routine analgesia (RA) and fascia iliaca compartment block (FICB) groups. Inter-group differences were compared via VAS scores at rest and during movement, Harris hip scores (HHS), presence of complications, adverse events after surgery, and length of hospital stay.

Results

The FICB group VAS scores at rest at 6 hour, 1 and 3 days, and 1 week after surgery were significantly lower than the RA group (P < .05). Moreover, the FICB group VAS scores with movement were markedly lower at 6 hour, 1 and 3 days, as well as 1 and 2 weeks after surgery (P < .05). The HHS of the FICB and RA groups were (53.41±8.63) and (40.02±9.61), respectively, on the seventh day after surgery, and the difference was statistically significant (P < .05). The incidence of postoperative complications and adverse events in the FICB group were not statistically different from the RA group. The average hospital stay of the FICB group was 2.12 days shorter than the RA group, but the difference did not reach statistical significance (P = .13).

Conclusion

FICB provides superior analgesic effect both at rest and with movement, along with rapid short-term recovery of hip function following surgery in elderly patients with hip fracture, without increasing postoperative complications or adverse events.

中文翻译：

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围手术期髂筋膜间室阻滞对老年髋部骨折患者术后疼痛及髋关节功能的影响

目的

在老年髋部骨折患者中，疼痛管理是一个具有挑战性的问题。尽管髋关节手术后获得公认的临床结果，但疼痛和恢复时间延长是与康复过程相关的最困难的后果。本研究的目的是评估老年髋部骨折患者围手术期与髂筋膜隔室阻滞（FICB）相关的疼痛缓解和功能改善。

患者和方法

本研究纳入 2019 年 1 月至 2020 年 12 月入住我院的 120 名老年髋部骨折患者。参与者随后被随机分为常规镇痛（RA）组和髂筋膜间室阻滞（FICB）组。通过休息和运动期间的 VAS 评分、Harris 髋关节评分 (HHS)、并发症的存在、手术后的不良事件和住院时间来比较组间差异。

结果

FICB组术后6小时、1天、3天、1周静息时VAS评分显着低于RA组（P <0.05）。此外，FICB 组运动的 VAS 评分在术后 6 小时、1 天和 3 天以及术后 1 和 2 周显着降低（P < .05）。FICB组和RA组术后第7天HHS分别为（53.41±8.63）和（40.02±9.61），差异有统计学意义（P <.05）。FICB组术后并发症和不良事件的发生率与RA组无统计学差异。FICB组平均住院时间比RA组短2.12天，但差异无统计学意义（P= .13)。

结论

FICB 在静息和运动时均提供卓越的镇痛效果，同时在老年髋部骨折患者术后短期内快速恢复髋部功能，且不会增加术后并发症或不良事件。