Gây tê khoang mạc chậu trên dây chằng bẹn dưới hướng dẫn của siêu âm bằng ropivacain cho phẫu thuật thay khớp háng

Hip replacement surgery is a rapidly growing procedure globally, with an increasing number of patients, including a younger demographic. Effective postoperative pain management is crucial for facilitating early rehabilitation and improving patient outcomes. While various analgesic techniques exist, including epidural and lumbar plexus blocks, concerns regarding side effects and hemodynamic instability persist. The fascia iliaca block (FIB) has emerged as a promising alternative for lower limb surgeries, particularly the supra-inguinal approach. However, comprehensive studies evaluating the efficacy and safety of ultrasound-guided supra-inguinal fascial iliaca block (US-S-FIB) using Ropivacaine specifically for hip replacement surgery, especially in the Vietnamese context, remain limited. This study aims to address this gap by providing valuable insights into this method.

Anesthesiologists, orthopedic surgeons, pain management specialists, and researchers interested in regional anesthesia techniques for hip replacement surgery.

This descriptive study investigated the analgesic efficacy and safety of ultrasound-guided supra-inguinal fascial iliaca block (US-S-FIB) with Ropivacaine for postoperative pain management following hip replacement surgery. Conducted on 30 ASA I-III patients at Viet Duc University Hospital, the study involved administering a 20 ml bolus of 0.25% Ropivacaine, followed by a continuous infusion of 0.1% Ropivacaine via an intermittent pump (20 ml every 6 hours), all guided by ultrasound. The average technique time was approximately 11.43 minutes, and patients consistently reported good pain relief, with VAS scores typically below 4 at all measured times, both at rest and during movement. Importantly, the method demonstrated a favorable safety profile, with no recorded incidences of hypotension, respiratory failure, nausea, vomiting, urinary retention, or local anesthetic toxicity. Mild quadriceps weakness (Bromage score 1.13 ± 0.35) was noted but did not hinder early mobilization. This research concludes that US-S-FIB with Ropivacaine, delivered via a programmed autobolus intermittent mode, offers significant postoperative pain relief for hip replacement patients. Its safety, minimal impact on hemodynamics and respiration, and fewer side effects make it a valuable alternative, potentially reducing the need for systemic analgesics and allowing for a lower overall anesthetic dose. These findings suggest that this technique can enhance patient comfort and recovery, particularly in cases where traditional pain relief methods are contraindicated or pose higher risks.