Comparison of the suprainguinal fascia iliaca compartment block with continuous epidural analgesia in patients undergoing hip surgeries: a retrospective study
Comparação do bloqueio do compartimento da fáscia ilíaca suprainguinal com analgesia peridural contínua em pacientes submetidos a cirurgias de quadril: um estudo retrospectivo
Background and objective
Pain control is one of the major concerns after major hip surgeries. Suprainguinal fascia iliaca compartment block (S-FICB) is an alternative analgesic technique that can be considered as an effective and less invasive method than epidural analgesia (EA). In this retrospective study, we compared postoperative analgesic efficacy of single shot ultrasound guided S-FICB and EA after major hip surgery.
We retrospectively examined 150 patients who underwent major hip surgeries and who received S-FICB or EA. 72 patients were submitted to EA and 78 patients received S-FICB wereincluded and their medical records retrospectively reviewed. Morphine consumptions, VAS scores and side effects were recorded. Patients under antiplatelet or anticoagulant theraphy were also registered. Morphine consumption and VAS scores were the primary endpoints, succes rate and complications were the secondary endpoints of our study. P-values less than 0.05 were considered statistically significant.
Morphine consumption was lower at the emergence in the EA group but there was no statistically significant difference between the two groups according to total opioid consumption (0 [0-0] vs 0 [0-0];p = 0.52). There was no difference between VAS scores in the first 18 hours. Hypotension was significantly higher in the EA group (9 vs 21; p = 0.04).
In conclusion, S-FICB can provide comparable analgesia with EA in the early postoperative period after hip surgery but VAS scores were found lower in the EA group than S-FICB group after 18th hour. Hypotension has occured more frequently in patients receiving EA.
Justificativa e objetivo: O controle da dor é uma das principais preocupações após grandes cirurgias do quadril. O bloqueio do compartimento da fáscia ilíaca suprainguinal (S-FICB) é uma técnica analgésica alternativa que pode ser considerada um método eficaz e menos invasivo que a analgesia epidural (AE). Neste estudo retrospectivo, comparamos a eficácia analgésica pós-operatória de S-FICB guiado por ultrassom e EA após grande cirurgia de quadril. Métodos: Examinamos retrospectivamente 150 pacientes submetidos a grandes cirurgias de quadril e que receberam S-FICB ou EA. 72 pacientes foram submetidos a EA e 78 pacientes receberam S-FICB foram incluídos e seus prontuários revisados retrospectivamente. Consumos de morfina, pontuações EVA e efeitos colaterais foram registrados. Pacientes em terapia antiplaquetária ou anticoagulante também foram registrados. O consumo de morfina e os escores EVA foram os desfechos primários, a taxa de sucesso e as complicações foram os desfechos secundários de nosso estudo. Valores de p inferiores a 0,05 foram considerados estatisticamente significativos. Resultados: O consumo de morfina foi menor na emergência no grupo EA, mas não houve diferença estatisticamente significativa entre os dois grupos de acordo com o consumo total de opioides (0 [0-0] vs 0 [0-0]; p = 0,52). Não houve diferença entre os escores EVA nas primeiras 18 horas. A hipotensão foi significativamente maior no grupo EA (9 vs 21; p = 0,04). Conclusão: Em conclusão, S-FICB pode fornecer analgesia comparável com EA no pós-operatório imediato após cirurgia de quadril, mas os escores VAS foram encontrados mais baixos no grupo EA do que no grupo S-FICB após 18 horas. Hipotensão ocorreu com mais frequência em pacientes recebendo EA.
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