Abstract PR343

Abstract

Background & Objectives: Providing satisfactory and safe analgesia is a major challenge for elder patients with hip fractures.The aim of this study was to compare the analgesia efficacy and safety between continuous fascia iliaca block analgesia (CFIB) and patient-controlled intravenous analgesia (PCIA)in elder patients undergoing hip fracture surgery. Materials & Methods: 32 patients (ASA II-III, ages 66-90 years old) scheduled for hip fracture surgeries were randomized into two groups. Patients of Group CFIB were placed a fascia iliaca catheter under ultrasound guidance and 30mL 0.33% ropivacaine was injected via the catheter before standardized general anesthesia. After surgery, a continuous infusion of 0.15% ropivacaine at rate of 2mL/h via the catheter, and a bolus of 30ml 0.15% ropivacaine was injected every 24h for 3 days after surgery. Patients of Group PCIA received standardized general anesthesia and intravenous patient-controlled analgesia using sufentanil for 3 days after surgery Results: There was no difference in pain intensity during movement (dynamic VAS) and rest (static VAS) before a bolus injection between the two groups 24h, 48h and 72 h after surgery. After a bolus injection, both the static and dynamic VAS decreased in Group CFIB, but only the VAS in 24h postoperatively was found difference, and compared to Group PCIA, only the static VAS was found difference. There was no difference in analgesic rescue between the two groups. Fewer side effect and better cooperation were found in Group CFIB. In Group PCIA, three patients removed the PCA devices because of nausea and vomiting. And a delirium and a respiratory depression in post anesthesia care unit respectively were found.Conclusion: These preliminary results showed similar analgesia efficacy between continuous fascia iliaca block and patient-controlled intravenous analgesia. Fewer side effect and better cooperation were found in continuous fascia iliaca block. Further studies are needed.