دورية أكاديمية
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Comparison of Suprainguinal Fascia Iliaca Nerve Block and Epidural Analgesia in Patients Undergoing Periacetabular Osteotomy.

التفاصيل البيبلوغرافية
العنوان: Comparison of Suprainguinal Fascia Iliaca Nerve Block and Epidural Analgesia in Patients Undergoing Periacetabular Osteotomy.
المؤلفون: VanEenenaam DP Jr; From the Division of Orthopedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA (VanEenenaam, Cardin, Yang, and Sankar), and the Division of General Anesthesiology (O'Brien and Muhly), Children's Hospital of Philadelphia, Philadelphia, PA., Cardin S, Yang D, O'Brien E, Muhly WT, Sankar WN
المصدر: The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2024 May 14. Date of Electronic Publication: 2024 May 14.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 9417468 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1940-5480 (Electronic) Linking ISSN: 1067151X NLM ISO Abbreviation: J Am Acad Orthop Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2016- : Philadelphia : Wolters Kluwer
Original Publication: Rosemont, IL : American Academy of Orthopaedic Surgeons, c1993-
مستخلص: Introduction: Adequate pain control and early mobilization are critical in the postoperative period after periacetabular osteotomy (PAO). Regional anesthesia can reduce postoperative pain, but certain techniques can increase the risk of postoperative motor block and delayed functional recovery. Continuous lumbar epidurals can provide excellent analgesia but also create challenges with early ambulation. Recently, suprainguinal fascia iliaca (SIFI) single-shot blocks have been shown to provide effective analgesia in PAO patients. The goal of this study was to compare opioid use, time to achieve inpatient physical therapy (PT) goals, and length of stay (LOS) between a cohort of patients receiving SIFI blocks and a cohort of patients receiving epidural analgesia (EA).
Methods: This retrospective single-surgeon comparative cohort study included all patients who underwent a PAO between 2012 and 2022. Regional anesthetic technique (SIFI vs EA), length of hospital stay, intraoperative and postoperative opioid use, pain scores, and time to achievement of PT milestones before discharge were recorded. Patients were excluded if they had any preexisting neuromuscular syndrome or neurosensory deficit. All opioid use was converted to morphine-milligram equivalents using standard conversions.
Results: Two hundred four surgeries were done over the study period; 164 patients received EA, and 40 received a SIFI block. The average age of our cohort was 19.5 years (±6 yrs). The SIFI cohort had a significantly shorter mean LOS than the EA cohort (2.9 vs 4.1 days, P < 0.001). Patients in the SIFI cohort achieved all PT ambulation goals significantly sooner than the lumbar epidural group (P < 0.001), with lower total opioid use on each postoperative day. No notable differences were observed in sex, race, BMI, or pain scores at inpatient PT visits before discharge.
Conclusion: After PAO surgery, the SIFI block is associated with shorter hospital LOS, reduced postoperative opioid use, and earlier mobilization when compared with those who were managed with an epidural.
(Copyright © 2024 by the American Academy of Orthopaedic Surgeons.)
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تواريخ الأحداث: Date Created: 20240515 Latest Revision: 20240515
رمز التحديث: 20240516
DOI: 10.5435/JAAOS-D-24-00177
PMID: 38748895
قاعدة البيانات: MEDLINE
الوصف
تدمد:1940-5480
DOI:10.5435/JAAOS-D-24-00177