[Continuous fascia iliaca compartment block combined with oral analgesics for pre-operative pain control in elderly hip fracture patients].

Objective The purpose of this study was to assess the efficacy of ultrasound-guided continuous fascia iliaca compartment block combined with oral analgesics for pre-operative pain control in elderly patients with hip fracture. Methods One hundred and sixteen patients with hip fractures in Xuan Wu Hospital of Capital Medical University during Dec. 2015 to Dec. 2016 were included. These patients were randomized into 2 groups: control group (group C) (receiving the traditional analgesia: tramadol 50 mg and paracetamol 500 mg tid, po from admission to surgery), study group (group S) (receiving ultrasound-guided continuous fascia iliaca compartment block combined with oral analgesics for pre-operative pain control from admission to surgery). Pain relief or pain intensity was assessed preoperatively at before administration of analgesia (T0), 1 h after administration of analgesia (T1), the second day after admission(T2), in the morning of surgery day (before surgery) (T3) using a visual analog scale. The satisfaction score with the analgesic regimen preoperatively was recorded. The amount of rescue analgesia, occurrence of adverse events (nausea, vomiting, respiratory depression, over sedation) and continuous fascia iliaca compartment block complications were also collected. Results Pain scores (VAS) at passive movement of group S were significantly lower at T1 (32±8), T2 (32±8) and T3 (34±7) than that at T0 (73±12) (all P<0.05). VAS at rest of group S were significantly lower than those of group C at T3 (t=3.488, P<0.05). VAS at passive movement of group S were significantly lower than those of group C at T1,T2,T3 (P<0.05). The satisfaction score with the analgesic regimen was greater in group S (74±10) than that in group C (46±11) (t=-14.209, P<0.05). The incidence of rescue analgesia was lower in group S (0) than in group C (17.2%) (χ2=5.472, P<0.05). The occurrence of nausea and vomiting was 6.9% and 1.7% in group S, which were lower than that in group C (22.4%, 12.1%) (χ2=6.779, 2.416, all P<0.05). There were no obvious complications of continuous fascia iliaca compartment block in group S. Conclusion Ultrasound guided continuous fascia iliaca compartment block combined with oral analgesics preoperatively is an effective way of providing analgesia for elderly with hip fracture, which can improve the patient's comfort and satisfaction. Key words: Hip fracture; Ultrasound-guided fascia iliaca compartment block; Analgesia; Aged