Hourglass Pattern:a Safe and Effective Method of Ultrasound-guided Fascia Iliaca Compartment Block / 中国微创外科杂志

ABSTRACT

Objective To confirm the efficacy of the “Hourglass Pattern”of ultrasound-guided fascia iliaca compartment block (FICB). Methods Approved by the medical ethics committee,we selected 30 patients undergoing selective total hip arthroplasty (THA ) in our hospital between January and May 2014.Before neuraxial anesthesia,ultrasound-guided FICB was performed.After identification of the “Hourglass Pattern”(internal oblique muscle and the sartorius muscle),a catheter was inserted. The sheath between the fascia iliaca and the iliacus muscle was distended with 40 ml of 0.2% ropivacaine,and then a continuous infusion of ropivacaine at a rate of 10 ml /h was administered for 48 h.Loss of sensation in the distribution areas of the femoral nerve and lateral femoral cutaneous nerve within 30 min was recorded.Patients were interviewed at 4 h,8 h,12 h,24 h,36 h and 48 h after block for pain intensity.Patients’ satisfaction scores at 48 h after block and the occurrence of adverse events (infection,local anesthetic toxicity,hemorrhage and hematoma)was recorded. Results The successful rate of the block was 100% without any adverse events.The median of numerical rating pain scale (NRPS)was below 4 points at 4 h,8 h,12 h,24 h,36 h and 48 h after block,and the patients’satisfaction score was (8.0 ±0.9 )points at 48 h after block.No adverse events occurred. Conclusions Ultrasound-guided FICB by using the “Hourglass Pattern”technique can offer effective analgesia after THA.It’s a safe method and can be easily performed.