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Objective To investigate the effect of fascia iliaca compartment nerve block ( FICB) to early analgesia and emergence agitation for children after the operation of femur fractures, and compare with fentanyl.Methods Totally 36 cases of children, which scheduled for the one-sided femur fractures surgery were selected after the approval from the Institutional Review Board of the hospital.They were randomly di-vided into two groups:FI group ( FICB group) and FE group ( Intravenous fentanyl group) .Patients in both groups were received ultrasound guided FICB immediately after the induction of general anesthesia, 1 ml/kg ropivacaine ( Naropin) was given in the FI group and 1 ml/kg saline in the FE group, sevoflurane was used for the anesthesia maintenance and 1 μg/kg intravenous fentanyl in FE group, instead of the same volume saline in FI group at 10 min before the surgery finished, and patients were sent to postanesthesia care unit ( PACU) after extubation.Keep a record of the duration of the operation and extubation, the pain scores and the Pediatric Agitation and Emergence Delirium ( PAED) scores were recorded at just arrived at PACU ( T0 ) , 10 min ( T1 ) , and 20 min ( T3 ) after PACU, also included the duration in PACU and the postopera-tively side effects.Results At the time of T0 and T1 , the pain scores in FI group was significantly lower than the FE( P 0.05), but it was still lower in FI group from the age of 8 to 14( P <0.05);The PAED scores at the three time points were always lower in FI group when it was compared with FE group;the same trend occurred for the duration of extubation and PACU( P <0.05).Conclusions FICB can effectively reduce emergence agitation and the pain scores for the children undergoing the surgery of femur fractures during the early time after the operation, which is better than the intravenous fentanyl.
RESUMO
Objective To research the 50% effective anesthetic volume ( EAV50) of 0.5% ropivacaine in nerve stimulator-guided vertical infraclavicular brachial plexus block. Methods Thirty patients scheduled for forearm or hand surgery were blocked using 0. 5% ropivacaine in nerve stimulator-guided vertical infraclavicular brachial plexus block. The EAV50, which is the anesthetic volume corresponding to 50% success and 50% failure was determined by up-and-down sequential test. The starting dose of 0. 5% ropivacaine was 0. 55ml/kg. Block failure resulted in a dose increase 110% , and block success in a reduction 110%. The sensory and motor blockade were accessed at 5- min intervals (up to 60 min). Results In nerve stimulator-guided vertical infraclavicular brachial plexus block, EAV50 for 0.5% ropivacaine was 0.417ml/kg. In up-and-down sequential test, there were significantly different in the block success rates of lateral, medial and posterior cord ( P <0.01). Conclusion In nerve stimulator-guided vertical infraclavicular brachial plexus block, enough anesthetic volume must be given to increase block success rates of all the cords of brachial plexus, and EAV50 for 0. 5% ropivacaine was 0.417ml/kg.
