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  • Title: Single injection fascia iliaca block for pain control after arthroscopic anterior cruciate ligament reconstruction: a randomized, controlled trial.
    Author: Wongswadiwat M, Pathanon P, Sriraj W, Yimyaem PR, Bunthaothuk S.
    Journal: J Med Assoc Thai; 2012 Nov; 95(11):1418-24. PubMed ID: 23252208.
    Abstract:
    BACKGROUND: Arthroscopic anterior cruciate ligament reconstruction (AACLR) is one of the orthopedic surgeries associated with moderate to severe post-operative pain. The fascia iliaca block (FIB), a block of the femoral nerve and lateralfemoral cutaneous nerve of the thigh, is relatively simple, safe, and provides effective analgesia post-operatively OBJECTIVE: To investigate the effectiveness of using fascia iliaca block for post-operative pain relief after AACLR. MATERIAL AND METHOD: After approval by the Ethics Committee for Khon Kaen University (HE510817), the patients were randomly allocated into two groups using a computer-generated random number and concealed by sealed opaque envelopes. FIB was delivered via a 16-gauge Tuohy needle at the PACU. The patients received either 0.2 % bupivacaine with adrenaline or 0.9% NSS 40 mL. Morphine consumption, time to first rescue analgesia, Numerical Rating Scale (NRS), side effects, and complication within 24 hours were recorded RESULTS: Forty-seven patients were enrolled. There was a statistically significant difference in the 24 hours morphine consumption between the bupivacaine and NSS groups (22.1 +/- 7.2 and 31.8 +/- 9.3 mg, respectively; p < 0.001). Time to first rescue analgesia was significantly longer in the bupivacaine group (4.60 +/- 2.2 vs. 2.83 +/- 1.6 hour p 0.003). The difference of resting and on movement pain score were also significant (2.1 (95% CI 1.3-2.8), p < 0.001 and 1.8 (95% CI 1.2-2.4), p < 0.001 respectively. Neither serious side effect nor neurological sequel was found. CONCLUSION: The fascia iliaca block is effective for providing pain control for at least 24 hours after anterior cruciate ligament reconstruction. This technique is quite easy, safe, and inexpensive to use.
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