Abstract
Supra inguinal fascia iliaca compartment block (FICB) is increasingly used in elderly patients with hip fractures. However, the minimum effective volume of local anesthetics required for ultrasound-guided supra-inguinal FICB has not been determined. With ethical committee approval and written informed consent from patients, we studied 21 consecutive patients of ASA physical status I–III undergoing surgery for hip fracture who met the inclusion criteria. Blocks were performed before going to the operation room. We determined the injection volumes of 0.25% ropivacaine for consecutive patients from the preceding patient's outcome. The initial volume was 30 ml. The testing interval was set at 10 ml, and the lowest volume was 5 ml. An effective block was defined as loss of sensation of pinprick in the territory of the femoral nerve and lateral cutaneous nerve of the thigh 30 min after the injection. The aim of this study was to determine the 50% effective volume (EV50) and the 95% effective volume (EV95) of 0.25% ropivacaine for ultrasound-guided supra-inguinal FICB using Logistic regression analysis. EV50 and EV95 of 0.25% ropivacaine for ultrasound-guided supra-inguinal FICB calculated with logistic regression analysis were 15.01 ml (95% confidence interval, 6.53–22.99 ml) and 26.99 ml (95% confidence interval, 20.54–84.09 ml), respectively. EV50 and EV95 of 0.25% ropivacaine for ultrasound-guided supra-inguinal FICB were 15.01 ml and 26.99 ml, respectively.Clinical trial number: UMIN000027277 (URL https://www.umin.ac.jp/ctr/index-j.htm).
Highlights
Supra inguinal fascia iliaca compartment block (FICB) is increasingly used in elderly patients with hip fractures
A modified supra-inguinal approach of FICB was reported in 2 0076 and clinical randomized trials reported that the supra-inguinal approach provides better analgesia than infra-inguinal approach in patients presenting for total hip arthroplasty[10,11]
This study examined patients categorized as physical status I–III according to the American Society of Anesthesiologist (ASA) and undergoing surgery for hip fracture
Summary
Supra inguinal fascia iliaca compartment block (FICB) is increasingly used in elderly patients with hip fractures. The minimum effective volume of local anesthetics required for ultrasound-guided supra-inguinal FICB has not been determined. The aim of this study was to determine the 50% effective volume (EV50) and the 95% effective volume (EV95) of 0.25% ropivacaine for ultrasound-guided supra-inguinal FICB using Logistic regression analysis. EV50 and EV95 of 0.25% ropivacaine for ultrasound-guided supra-inguinal FICB calculated with logistic regression analysis were 15.01 ml (95% confidence interval, 6.53–22.99 ml) and 26.99 ml (95% confidence interval, 20.54–84.09 ml), respectively. In patients with hip fracture, the pain management is often treated with opioids. In FICB, local anesthetics are injected into the fascia iliaca compartment, spread to the femoral and lateral cutaneous nerves of the thigh. A modified supra-inguinal approach of FICB was reported in 2 0076 and clinical randomized trials reported that the supra-inguinal approach provides better analgesia than infra-inguinal approach in patients presenting for total hip arthroplasty[10,11]
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