The purpose of this study was to assess the efficacy of ultrasound-guided continuous fascia iliaca compartment block combined with oral analgesics for pre-operative pain control in elderly patients with hip fracture. One hundred and sixteen patients with hip fractures in Xuan Wu Hospital of Capital Medical University during Dec. 2015 to Dec. 2016 were included. These patients were randomized into 2 groups: control group (group C) (receiving the traditional analgesia: tramadol 50 mg and paracetamol 500 mg tid, po from admission to surgery), study group (group S) (receiving ultrasound-guided continuous fascia iliaca compartment block combined with oral analgesics for pre-operative pain control from admission to surgery). Pain relief or pain intensity was assessed preoperatively at before administration of analgesia (T), 1 h after administration of analgesia (T), the second day after admission(T), in the morning of surgery day (before surgery) (T) using a visual analog scale. The satisfaction score with the analgesic regimen preoperatively was recorded. The amount of rescue analgesia, occurrence of adverse events (nausea, vomiting, respiratory depression, over sedation) and continuous fascia iliaca compartment block complications were also collected. Pain scores (VAS) at passive movement of group S were significantly lower at T (32±8), T (32±8) and T (34±7) than that at T (73±12) (all <0.05). VAS at rest of group S were significantly lower than those of group C at T (=3.488, <0.05). VAS at passive movement of group S were significantly lower than those of group C at TTT (<0.05). The satisfaction score with the analgesic regimen was greater in group S (74±10) than that in group C (46±11) (=-14.209, <0.05). The incidence of rescue analgesia was lower in group S (0) than in group C (17.2%) (χ=5.472, <0.05). The occurrence of nausea and vomiting was 6.9% and 1.7% in group S, which were lower than that in group C (22.4%, 12.1%) (χ=6.779, 2.416, all <0.05). There were no obvious complications of continuous fascia iliaca compartment block in group S. Ultrasound guided continuous fascia iliaca compartment block combined with oral analgesics preoperatively is an effective way of providing analgesia for elderly with hip fracture, which can improve the patient's comfort and satisfaction.
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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2018.10.002 | DOI Listing |
J Clin Med
December 2024
Anesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
Mediastinal mass syndrome represents a major threat to respiratory and cardiovascular integrity, with difficult evidence-based risk stratification for interdisciplinary management. We conducted a narrative review concerning risk stratification and difficult airway management of patients presenting with a large mediastinal mass. This is supplemented by a case report illustrating our individual approach for a patient presenting with a subtotal tracheal stenosis due to a large cyst of the thyroid gland.
View Article and Find Full Text PDFMil Med
January 2025
Department of Emergency Medicine, Mike O'Callaghan Military Medical Center, Las Vegas Blvd, NV 89191, USA.
Introduction: Regional anesthesia, specifically fascia iliaca compartment blocks (FICB), is highly effective in managing pain, especially in military settings. However, a significant barrier to its implementation is the lack of provider confidence in performing ultrasound-guided procedures. This study evaluates the ability of physician assistant (PA) students, who are often first-line providers in austere locations, to identify the fascia iliaca compartment (FIC) using point-of-care ultrasound (POCUS) after a brief training session and assesses their retention of this skill over a 60- to 90-day period.
View Article and Find Full Text PDFSci Prog
January 2025
Orthopaedics, Hospital Universitario Fundacion Santa Fe de Bogotá, Bogotá, Colombia.
Hospital admission due to fragility hip fracture has increased significantly in recent years. In patients with hip fracture, perioperative pain management is usually with opioids, whose dosage is difficult to adjust and have many side effects, especially in older adults. The purpose of this study was to determine the impact and the advantages of the implementation of the fascia iliaca blockade in older adults with hip fracture due to fragility included in the Orthogeriatric Clinical Care Center of the Fundación Santa Fe de Bogotá and the San José Infantil University Hospital in Bogotá, Colombia.
View Article and Find Full Text PDFInt J Gen Med
December 2024
Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Purpose: The routine perioperative use of opioids has recently been questioned due to opioid-related side effects, which can be potentially harmful in geriatric patients. This study aimed to evaluate the effects of opioid-free anesthesia in geriatric patients undergoing hip surgery.
Patients And Methods: A total of 121 patients, aged 60 years or older, undergoing elective hip surgery were randomized to receive either opioid-free anesthesia with dexmedetomidine and esketamine (OFA group) or balanced anesthesia with opioids (CON group).
Ann Emerg Med
January 2025
Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine, University of Pavia, Pavia, Italy.
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