Year :
2024
| Month :
April
| Volume :
18
| Issue :
4
| Page :
UC17 - UC21
Analgesic Efficacy of Ultrasound-guided Fascia Iliaca Block and Three-in-one Block in Elderly Patients Undergoing Hip Surgeries: A Randomised Double-blinded Clinical Trial
Urvashi Yadav, Usman Ghani, Jaybrijesh Singh Yadav, Shuchi Nigam, Amit Kumar Singh
1. Professor, Department of Anaesthesia, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.
2. Senior Resident, Department of Anaesthesia, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.
3. Associate Professor, Department of Anaesthesia, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.
4. Assistant Professor, Department of Anaesthesia, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.
5. Associate Professor, Department of Anaesthesia, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.
Correspondence Address :
Dr. Shuchi Nigam,
Assistant Professor, Department of Anaesthesia, Uttar Pradesh University of Medical Sciences, Saifai, Etawah-206130, Uttar Pradesh, India.
E-mail: shuchinigam@gmail.com
Abstract
Introduction: Hip surgery is a common surgical procedure in the elderly population, leading to significant pain. Ultrasound (USG) guided regional nerve blocks are a newer, safe, and effective postoperative pain control modality for elderly patients.
Aim: To compare the analgesic efficacy of Fascia Iliaca Compartment Block (FICB) with the three-in-one block for postoperative analgesia in elderly patients after lower limb orthopaedic surgeries.
Materials and Methods: It was a randomised double- blinded study performed at Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India on 60 elderly patients of Americian Soceity of Anaesthesiologists (ASA) class I-II scheduled for elective hip and femur shaft surgery under spinal anaesthesia.All patients were randomly allocated into two groups. Group A received ultrasound-guided FICB with 35-40 mL of 0.25% bupivacaine, and group B received ultrasound-guided three-in-one block with 35-40 mL of 0.25% bupivacaine after completion of surgery. In the postoperative period, pain was assessed using the Visual Analogue Scale (VAS), and inj. diclofenac sodium 1.5 mg/kg intravenous (i.v.) was given as rescue analgesic whenever VAS was ≥4. The primary outcome was changes in VAS scores at rest and during passive leg elevation between the two groups at various time intervals within 24 hours. Secondary outcomes measured were the duration of analgesia and total rescue analgesic required in 24 hours. Qualitative variables were compared between groups using the Chi-square test. A p-value<0.05 was considered statistically significant.
Results: Demographic data were comparable in both groups, with a mean age of 65.11±1.89 years in Group A and 65.57±1.46 years in Group B. The VAS score at rest was significantly lower in Group A compared to Group B at the 6th hour (1.21±1.17 vs. 1.61±0.78) and 12th hour (2.80±0.12 vs. 3.33±0.92), respectively. The VAS score during passive movement was significantly lower in Group A at the 6th hour and 12th hour compared to Group B. The mean time for the first demand of rescue analgesic was 9.27±2.16 hours in the Fascia Iliaca Compartment Block (FICB) group and 6.67±1.45 hours in the three-in-one group. The difference was significant, with a p-value of 0.006. The mean requirement of total rescue analgesia was 133.33±33.27 mg in Group A and 198.53±29.16 mg in Group B, which was statistically significant.
Conclusion: The fascia iliaca block had lower pain scores both at rest and during passive movement compared to the three-in-one block. Total analgesic requirement was lower in the fascia iliaca group compared to the three-in-one block group.
Keywords
Bupivacaine, Postoperative period, Rescue analgesia, Ultrasonography
DOI and Others
DOI: 10.7860/JCDR/2024/68049.19246
Date of Submission: Oct 13, 2023
Date of Peer Review: Jan 04, 2024
Date of Acceptance: Jan 18, 2024
Date of Publishing: Apr 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 14, 2023
• Manual Googling: Jan 06, 2024
• iThenticate Software: Jan 17, 2024 (7%)
ETYMOLOGY: Author Origin
EMENDATIONS: 5
|