PDF(Pubmed)
Abstract：
Hip arthroplasty is a common procedure with high costs and difficult rehabilitation. It causes postoperative pain, and this can reduce mobility which extends in-patient time. An optimal analgesia regime is crucial to identify. Opioids produce effective pain relief but are associated with nausea, vomiting, and respiratory depression which can hinder physiotherapy and discharge. Finding alternatives has been of interest in recent years, particularly fascial blocks. These are anaesthetic injections beneath fascia which spread to nerves providing pain relief from surgery and are used with a general or spinal anaesthetic. Two of these blocks which are of interest to total hip arthroplasty are the quadratus lumborum block and fascia iliaca block. Studies have investigated the effectiveness of these blocks through patient factors, primarily pain scores, opioid consumption, and other secondary outcomes such as ambulation and length of stay. This review takes a narrative approach and investigates the literature around the topic. Pain and opioid consumption were the most widely reported outcomes, reported in 90% and 86% of studies. 83% of these studies reported positive effects on pain scores when FIB was utilised. 80% of these studies reported positive effects on opioid consumption when FIB was used. When QLB block was utilised, pain and opioid consumption were positively impacted in 82% of studies. This paper has been written with the intention of reviewing current literature to give an impression of the effectiveness of the blocks and propose potential areas for future work on the blocks.
摘要：
髋关节置换术是一种常见的手术，成本高，康复困难。会导致术后疼痛,这可能会降低移动性，从而延长住院时间。确定最佳的镇痛方案至关重要。阿片类药物能有效缓解疼痛，但伴有恶心，呕吐,和呼吸抑制会阻碍理疗和出院。寻找替代品近年来引起了人们的兴趣，尤其是筋膜块。这些是筋膜下的麻醉注射，其扩散到神经，从手术中缓解疼痛，并与普通或脊柱麻醉剂一起使用。其中两个对全髋关节置换术感兴趣的块是腰方肌阻滞和髂筋膜阻滞。研究通过患者因素调查了这些阻滞的有效性，主要是疼痛评分，阿片类药物的消费，以及其他次要结果，如步行和住院时间。这篇综述采用了叙事的方法，并研究了围绕该主题的文献。疼痛和阿片类药物消耗是最广泛报道的结果，90%和86%的研究报告。这些研究中有83％报告了使用FIB对疼痛评分的积极影响。这些研究中有80％报告了使用FIB对阿片类药物消耗的积极影响。当使用QLB块时，在82%的研究中,疼痛和阿片类药物的消耗受到积极影响.撰写本文的目的是回顾当前的文献，以给人以块的有效性印象，并为块的未来工作提出潜在的领域。
