Study On The Effect Of Lumbar Plexus Diffusion Of Improved Supra-inguinal Fascia Iliaca Compartment Block Under Ultrasound Guidance

Background and purpose:Fascia iliaca compartment block(FICB)is defined as lumbar plexus block in the anterior approach and is commonly used for anesthesia and analgesia during lower limb surgery.The femoral nerve(FN),lateral femoral cutaneous nerve(LFCN)and obturator nerve(ON)are the target nerves for FICB.At present,supra-inguinal fascia iliaca compartment block(S-FICB)under the guidance of ultrasound is the most commonly used method.We have improved in operation on S-FICB,that is,improved supra-inguinal fascia iliaca compartment block(IS-FICB),which is to observe the onset time and lumbar plexus diffusion effect of IS-FICB and S-FICB on the target nerve block at the same local anesthetic dose through preoperatively nerve block.Method:In this study,40 patients undergoing unilateral lower limb surgery were randomly divided into the IS-FICB group and the S-FICB group,both of who are with 0.25% ropivacaine hydrochloride(20 ml)before surgery injected.The onset time of sensory blockade in the target innervated region,the change of muscle strength of quadriceps femoris and adductor muscles,and the effect of lumbar plexus diffusion were mainly evaluated.Results:1.Both IS-FICB and S-FICB could completely block FN and LFCN by using20 ml local anesthetics.2.IS-FICB group and S-FICB group FN block onset time comparison(2.75±1.37 min VS 4.1±1.87 min,p=0.01),LFCN block onset time comparison(1.80±0.89 min VS 2.60±1.19 min,p=0.021),The difference was statistically significant.3.The success rate of ON block in IS-FICB and S-FICB(75% VS 70%,p>0.05),no statistically significant difference exists.4.The success rate of ilioabdominal nerve and ilioinguinal nerve block in IS-FICB group and S-FICB group(60% VS 70%,p > 0.05),no statisticallysignificant difference exists.Conclusion:1.S-FICB and IS-FICB can completely block FN and LFCN with 0.25%ropivacaine hydrochloride 20 ml.2.Compared with S-FICB,IS-FICB can shorten the block time of FN and LFCN.3.There was no significant difference in lumbar plexus diffusion between SFICB and IS – FICB.