TY - JOUR

T1 - Systematic review of the effects of fascia iliaca compartment block on hip fracture patients before operation

AU - Steenberg, J

AU - Møller, A M

N1 - Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

PY - 2018/6

Y1 - 2018/6

N2 - BACKGROUND: Fascia iliaca compartment block is used for hip fractures in order to reduce pain, the need for systemic analgesia, and prevent delirium, on this basis. This systematic review was conducted to investigate the analgesic and adverse effects of fascia iliaca block on hip fracture in adults when applied before operation.METHODS: Nine databases were searched from inception until July 2016 yielding 11 randomised and quasi-randomised controlled trials, all using loss of resistance fascia iliaca compartment block, with a total population of 1062 patients. Meta-analyses were conducted comparing the analgesic effect of fascia iliaca compartment block on nonsteroidal anti-inflammatory drugs (NSAIDs), opioids and other nerve blocks, preoperative analgesia consumption, and time to perform spinal anaesthesia compared with opioids and time for block placement.RESULTS: The analgesic effect of fascia iliaca compartment block was superior to that of opioids during movement, resulted in lower preoperative analgesia consumption and a longer time for first request, and reduced time to perform spinal anaesthesia. Block success rate was high and there were very few adverse effects. There is insufficient evidence to conclude anything on preoperative analgesic consumption or first request thereof compared with NSAIDs and other nerve blocks, postoperative analgesic consumption for preoperatively applied fascia iliaca compartment block compared with NSAIDs, opioids and other nerve blocks, incidence and severity of delirium, and length of stay or mortality.CONCLUSIONS: Fascia iliaca compartment block is an effective and relatively safe supplement in the preoperative pain management of hip fracture patients.

AB - BACKGROUND: Fascia iliaca compartment block is used for hip fractures in order to reduce pain, the need for systemic analgesia, and prevent delirium, on this basis. This systematic review was conducted to investigate the analgesic and adverse effects of fascia iliaca block on hip fracture in adults when applied before operation.METHODS: Nine databases were searched from inception until July 2016 yielding 11 randomised and quasi-randomised controlled trials, all using loss of resistance fascia iliaca compartment block, with a total population of 1062 patients. Meta-analyses were conducted comparing the analgesic effect of fascia iliaca compartment block on nonsteroidal anti-inflammatory drugs (NSAIDs), opioids and other nerve blocks, preoperative analgesia consumption, and time to perform spinal anaesthesia compared with opioids and time for block placement.RESULTS: The analgesic effect of fascia iliaca compartment block was superior to that of opioids during movement, resulted in lower preoperative analgesia consumption and a longer time for first request, and reduced time to perform spinal anaesthesia. Block success rate was high and there were very few adverse effects. There is insufficient evidence to conclude anything on preoperative analgesic consumption or first request thereof compared with NSAIDs and other nerve blocks, postoperative analgesic consumption for preoperatively applied fascia iliaca compartment block compared with NSAIDs, opioids and other nerve blocks, incidence and severity of delirium, and length of stay or mortality.CONCLUSIONS: Fascia iliaca compartment block is an effective and relatively safe supplement in the preoperative pain management of hip fracture patients.

KW - Analgesics, Opioid/administration & dosage

KW - Bias

KW - Drug Administration Schedule

KW - Fascia Lata

KW - Hip Fractures/surgery

KW - Humans

KW - Nerve Block/methods

KW - Pain Management/methods

KW - Pain, Postoperative/prevention & control

KW - Preoperative Care/methods

U2 - 10.1016/j.bja.2017.12.042

DO - 10.1016/j.bja.2017.12.042

M3 - Journal article

VL - 120

SP - 1368

EP - 1380

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 6

ER -