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Master Thesis

Stratégie analgésique dans la prise en charge des fractures du col du fémur traitées par prothèses

Abstract : Purpose: Pain control in femoral neck fracture treated with THA or HA leads to early rehabilitation. The goal of surgical pain management is to allow early mobilization and reduce opiods consumption. Peripheral nerve blocks and Local infiltration anesthesia seem to be a good solution to meet these objectives. In CHU SUD Reunion, we compared 3 hip analgesia techniques: Fascia-iliaca Block(FIB), PENG block (PENG) and Local Infiltration Anesthesia (LIA) Methods : Single-center and retrospective study including all patients operated on by hip prosthesis on fracture from May to September 2021 and having benefited either from an Iliofascial Block, or from a PENG block, or From a surgical infiltration of local anesthetic. The primary endpoint was the assessment of pain on a visual analogue scale, on mobilization at 24 hours. The secondary endpoints were: consumption of opioids at 24 hours, time before first getting up, spontaneous pain at 12, 24 and 48 hours postoperatively. Results: 32 patients were included in the study. 11 patients benefited from FIB, 10 from PENG block and 11 from LIA. Pain on mobilization and at rest were less in patients who received LIA and PENG block compared to those who received Fascia Iliaca block (p = 0.034 / p = 0.029). The 24-hour opioid consumption was low in the 3 groups, 19 out of 32 patients did not. Conclusion: LIA and PENG block appear to be more effective on pain than FIB. Our study and the data in the literature support our hypothesis that surgical infiltration is more effective than perineural.
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Master Thesis
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Submitted on : Tuesday, December 14, 2021 - 8:08:15 AM
Last modification on : Monday, January 10, 2022 - 11:47:12 AM
Long-term archiving on: : Tuesday, March 15, 2022 - 6:18:23 PM


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  • HAL Id : dumas-03478551, version 1


Pierre Chirez. Stratégie analgésique dans la prise en charge des fractures du col du fémur traitées par prothèses. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03478551⟩



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