Effects of ultrasound-guided suprainguinal fascia iliaca block on post-operative recovery quality after free anterolateral thigh flaps repaire
Objective To investigate the effects of ultrasound-guided suprainguinal fascia iliaca block(SFIB)on peri-operative analgesia and postoperative recovery quality in repairing the wounds of limbs with free anterolateral thigh(ALT)flaps.Methods Seventy-nine patients with limb wounds repaired with free ALT flaps,aged 18-60 years,BMI 16-28 kg/m2,ASA physical status Ⅰ-Ⅲ were included.Patients were assigned into two groups according to random number table method:ultrasound-guided SFIB group(group F,n=39)and control group(group C,n=40).Ultrasound-guided SFIB was performed before anesthesia induction,and 30 ml of 0.375％ropivacaine and dexamethasone 5 mg were injected in group F.There was no nerve block in group C.All patients received the same general anesthesia regimen.The intrao-perative dosage of propofol,remifentanil,sufentanil,vasoactive drugs,anesthetic recovery time were recor-ded,NRS scores at rest immediately before leaving PACU and 2,6,12,24,and 48 hours after surgery,the valid number of pressing patient-controlled intravenous analgesia(PCIA)pump,the rate of rescue anal-gesia on postoperative day 1 and day 2,the 15-item quality of recovery(QoR-15)scores before operation,on postoperative day 1 and day 2,the incidence of postoperative adverse reactions(dizziness,nausea and vomiting,pruritus,respiratory depression,hypoxemia),the wound healing rates of donor sites,flap survival rates of reception sites and hospitalization time were recorded.Results Compared with group C,patients in group F required less remifentanil,sufentanil and vasoactive drugs for anesthesia maintenance(P＜0.05),the recovery time,the length of stay in PACU in group F were significantly decreased(P＜0.05),NRS scores at rest 2 and 6 hours after surgery were significantly decreased in group F(P＜0.05).The valid number of pressing PCIA pump,the need for rescue analgesia on postoperative day 1,the QoR-15 scores on postoperative day 1 and day 2 and the incidence of adverse reactions,including dizziness and nau-sea and vomiting within 48 hours after surgery in group F were significantly reduced(P＜0.05).There were no significant differences in dosage of propofol,NRS scores at rest immediately before leaving PACU,12,24,and 48 hours after surgery,as well as the valid number of pressing PCIA pump and the need for rescue analgesia on the second day after operation,the incidence of pruritus,respiratory depression and hy-poxemia within 48 hours after surgery,the wound healing rates of donor sites,flap survival rates of reception sites and hospitalization time between two groups.Conclusion Ultrasound-guided SFIB before surgery can relieve the postoperative pain significantly,reduce the peri-operative analgesic requirements,the incidence of opioid relevant complications and accelerate the early recovery for patients with limb wounds repaired with free ALT flaps.
Fascia iliaca blockUltrasound-guidanceGeneral anesthesiaAnterolateral thigh flap
万方数据
维普
