Effects Of Continuous Fascia Iliaca Compartment Block On Quality Of Recovery After Total Hip Arthroplasty In The Elderly

Background Total hip arthroplasty(THA)is one of the most common orthopedic surgeries,which can improve the quality of life in elderly patients.However,THA can cause severe postoperative acute pain that increase the incidence risk of complications,prolong hospital stay and increase the risk of death.Therefore,adequate postoperative analgesia is important to improve prognosis for elderly patients undergoing THA.Fascia iliaca compartment block is a valuable regional analgesia technique for hip surgery,however,it only provides effective analgesia for patients in a short period of time.Therefore,the implementation of continuous fascia iliaca compartment block(CFICB)has advantages for extending the time of postoperative analgesia.Quality of recovery after THA is an important clinical concern,however,there was no research that explore the effect of CFICB on quality of recovery after THA in the elderly.Objective This study was designed to evaluate the effect of CFICB on quality of recovery after THA in the elderly.Methods This study was a prospective and randomized controlled trial.Sixty elderly patients undergoing THA were randomly divided into two groups(30 cases in each group):the CFICB group or the patient controlled intravenous analgesia(PCIA)group.In the CFICB group,CFICB was carried out by the anesthetist after surgery;in the PCIA group,PCIA was used.Researcher assessed postoperative quality of recovery for patients using the Quality of Recovery-15(QoR-15)questionnaire.The primary outcome was the scores of QoR-15 which measured at 24 and 48 h after surgery.The secondary outcomes were the rest and movement VAS scores at 6,12,24 and 48 h after surgery;postoperative complications;number of cases with rescue analgesia;time of postoperative ambulation;the duration of the hospital stay;Bromage scores at 24 and 48 h postoperatively.Results A total of 56 patients were included,including 27 in the CFICB group and 29 in the PCIA group.Between the two groups,there was no significant difference in demographic and surgical data(P>0.05).The QoR-15 scores in CFICB group was higher than that in PCIA group at 24 h(P<0.05);there was no statistically significant difference in the QoR-15 scores at 48 h(P>0.05).The rest and movement VAS scores of the CFICB group were lower than those of the PCIA group at 12,24 and 48 h postoperatively(P<0.05).In CFICB group 2 patients felt dizzy compared with 9 patients in PCIA group,the difference was statistically significant(P<0.05).However,there were no significant difference between two groups in the number of patients with other postoperative complications,number of cases with rescue analgesia,time of postoperative ambulation and the duration of the hospital stay(P>0.05).The Bromage scores at 24 h postoperatively was statistically significant(P<0.05)and the Bromage scores at 48 h was no statistically significant difference between two groups(P>0.05).Conclusion Compared with PCIA,continuous fascia iliaca compartment block can improve early quality of recovery and reduce pain scores after total hip arthroplasty in the elderly,which is a safe and effective regional block technique.