NGHIÊN CỨU HIỆU QUẢ GIẢM ĐAU CỦA GÂY TÊ KHOANG MẠC CHẬU LIÊN TỤC BẰNG LEVOBUPIVACAINE SAU PHẪU THUẬT THAY KHỚP

Abstract

Objectives: To evaluate the analgesic efficacy of continuous fascia iliaca compartment block (FICB) with levobupivacaine following hip arthroplasty and its effects on some circulatory, respiratory parameters and adverse effects of the method. Methods: A prospective, descriptive uncontrolled study was conducted on 42 patients undergoing hip arthroplasty under spinal anaesthesia at the Department of Anesthesiology and Resuscitation, Military Hospital 175, from January 2025 to March 2026. Postoperatively, all patients received an ultrasound-guided fascia iliaca compartment catheter insertion and an injection of 30mL of levobupivacaine 0.2%, as well as an infusion of levobupivacaine 0.1% at 4 mL/hour for 72 hours. Results: The mean VAS (visual analogue score) at rest was below 3, and the mean VAS on movement was below 4 after levobupivacaine administration. Only 4.8% of cases required “pain rescue”. The percentage of satisfied and highly satisfied patients was 90.4%. Heart rate, systolic blood pressure, respiratory rate, and SpO₂ changed within physiological limits during 72 hours of FICB. Paraesthesia occurred in 40.5%; motor block at Bromage grade 1 and grade 2 was 31% and 11.9%, respectively. Pruritus, nausea and vomiting, and catheter site infection were 11.9%, 7.1%, and 2.4%, respectively. Conclusion: Continuous FICB with levobupivacaine provides effective pain control with minimal effects on respiration and circulation; adverse effects were transient and easily manageable after hip replacement surgery (hip arthroplasty) in the studied patient group.