[Application of ultrasound guidance for fascia iliaca compartment block in pediatric femoral surgery].
Objective:To evaluate the efficacy of ultrasound guidance for fascia iliaca compartment block in pediatric femoral surgery.Methods:This study was a prospective study, thirty children who were American Society of Anesthesiologists (ASA) statusⅠ with 5-10 years old scheduled for femoral surgery were selected in orthopedics department in Second Affiliated Hospital of Wenzhou Medical University from May to December in 2014. After induction of general anesthesia, all the children were inserted the laryngeal mask. Then they were received fascia iliaca compartment block using ultrasound guidance under sevoflurane inhalation anesthesia. The indicators including heart rate(HR), mean arterial pressure(MAP), oxygen saturation(SpO(2)) and exhaled sevoflurane concentration were recorded before skin incision(T(1)), at 1, 5, 10 min after incision(T(2)-T(4))and at the end of the surgery(T(5)). Postoperative pain were assessed using the pain behavior assessment scale at awake time, 2 h and 4 h after surgery. The efficacy of postoperative analgesia and the satisfaction of parents at 2 h and 4 h after surgery were recorded.Results:The differences between HR、MAP and SpO(2) in children at T(1)-T(5) were no statistical significance (allP>0.05). Exhaled sevoflurane concentration at T(1)-T(5) were(2.50±0.51)%, (2.51±0.42)%, (2.50±0.41)%, (2.54±0.31)% and(0.61±0.20)%, respectively, the differences were statistically significant(F=13.503,P<0.05), among them that at T(5) was significantly lower than at T(1)-T(4)(allP<0.05). The pain score at awake time, 2 h and 4 h after surgery were (1.6±0.7), (3.3±1.4) and (3.9±1.3) scores, respectively. The parents satisfaction were 87% and 73% at 2 h and 4 h afer surgery respectively.Conclusion:The way of ultrasound guidance for fascia iliaca compartment block combined with general anesthesia can be safely and effectively used in pediatric femoral surgery. Using the technique of ultrasonic imaging, the fascia iliaca compartment can be directly observed and then the local anesthetics is injected, therefore the efficacy of block is improved.
Department of Anesthesiology, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
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Yang
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Li
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D000779:Anesthetics, Local; D002648:Child; D005205:Fascia; D005269:Femur; D006801:Humans; D035002:Lower Extremity; D009407:Nerve Block; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain; D011446:Prospective Studies; D014463:Ultrasonography
D000779:Anesthetics, Local
Anesthesia; Child; Fascia; Femur; Nerve block; Ultrasonography