Item type:Thesis, Open Access

Femoralis-Katheter versus Fascia iliaca compartment Katheter nach Hüftgelenks-Endoprothesen: Welches Verfahren ist die bessere Alternative bezüglich postoperativer Analgesie und Funktionalität?

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Date

2010-07-08

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Philipps-Universität Marburg
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Abstract

BACKROUND: The efficacy of analgesia and the functional outcome of continuous femoral nerve (FEM) and fascia iliaca compartment blocks (FICB) were compared. METHODS: Eighty patients scheduled for total hip replacement were intended for this prospective trial and were randomly divided into two groups. Before surgery with the patients anesthetized, catheters were placed for continuous FEM by means of a nerve stimulator (group 1). In group 2, the catheter was inserted for continuous FICB without nerve stimulator but with a blunt 45° shape needle. In both groups, a 500mg prilocaine bolus was administered followed by continuous infusion of 10ml/h of 0.2% ropivacaine for 24 hours. In the postoperative period, both groups received enteral diclofenac 3x50mg and intravenous patient-controlled piritramid as rescue analgesia if the visual analog scale (VAS 0-10cm) pain values were greater than 3cm. In case of renal failure or other contraindications of diclofenac, the patients received instead of diclofenac metamizol 2,5g. 24h piritramid consumption, VAS 0-10cm pain values during the first three postoperative days and the functional outcome during the first three months post-operative (by means of neutral-0-method and questionnaires as harris hip score, lequesne index, WOMAC index and sf-36) were recorded. RESULTS: The patients of group 2 required more piritramid (in the median 15,0mg) than the patients of group 1 (in the median 24,8mg), but the difference was not significant (p = 0,26). No significant differences were observed between groups regarding VAS pain values and functional outcome. No major side effects were observed. CONCLUSION: This study suggests that FEM and FICB provide comparable effective pain relief and allow similar functional outcome after total hip arthroplasty. As patients with continuous FEM required less additional piritramid, it appears to offer the better option. No severe side effects were recorded.

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Dates
Created: 2010Issued: 2010-07-08Updated: 2011-08-10
DOI
https://doi.org/10.17192/z2010.0355
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
Funktionelles OutcomeFascia iliaca compartment BlockFemoral nerve blockAnästhesieRegionalanästhesieRegional anesthesiaCoxarthroplastyFemoralis-KatheterFascia iliaca compartment block
DFG-subjects
LokalanästhesieKatheterSchmerztherapieAnalgesieHüftgelenkprothese
DDC-Numbers
610
License
https://rightsstatements.org/vocab/InC-NC/1.0/
URI
https://open.uni-marburg.de/handle/10.17192/z2010.0355
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Benthaus, Sabine: Femoralis-Katheter versus Fascia iliaca compartment Katheter nach Hüftgelenks-Endoprothesen: Welches Verfahren ist die bessere Alternative bezüglich postoperativer Analgesie und Funktionalität?. : Philipps-Universität Marburg 2010-07-08. DOI: https://doi.org/10.17192/z2010.0355.

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