The effect of fascia iliaca compartment block on postoperative delirium in elder adults undergoing hip surgery: A systematic review and meta-analysis of randomized controlled trials.
Int J Orthop Trauma Nurs
; 54: 101122, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-39047334
ABSTRACT
OBJECTIVE:
This meta-analysis aimed to evaluate whether fascia iliaca compartment block (FIB) could reduce the incidence of postoperative delirium (POD) in elderly patients undergoing hip surgery.METHODS:
This meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42023490399). The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for randomized controlled trials (RCTs) till November 15, 2023. Review Manger 5.4 was used to analyze the data.RESULTS:
A total of 10 RCTs with 930 elderly patients were included in this meta-analysis. This meta-analysis indicated that FIB could reduce the incidence of POD in elderly patients undergoing hip surgery without preoperative cognitive impairment (OR0.46; 95%CI[0.22, 0.96], P = 0.04, I2 = 0%). Subgroup analysis of the incidence of POD showed that elderly patients who received FIB treatment before entering the operating room had a lower risk of developing POD(OR0.48; 95%CI[0.30, 0.76], P = 0.002, I2 = 0%), and FIB could reduce the occurrence of POD in patients undergoing intravertebral anesthesia instead of general anesthesia (OR0.37; 95%CI[0.20, 0.66], P﹤0.01, I2 = 0%). Moreover, FIB could reduce the MMSE score on the first day after surgery (SMD1.07; 95%CI[0.15, 1.99], P = 0.02, I2 = 86%). In addition, FIB could reduce the pain score on the first and third day after surgery (SMD -0.46; 95%CI[-0.74, -0.18], P = 0.001, I2 = 43%; SMD -0.62; 95%CI[-0.97, -0.26], P﹤0.001, I2 = 58%), as well as after physical activity(SMD -1.64; 95%CI[-3.00, -0.28], P = 0.02, I2 = 83%).CONCLUSION:
FIB can reduce the incidence of POD in elderly patients undergoing hip surgery without pre-existing cognitive impairment. Additionally, it can lower the delirium scores and pain scores.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Randomized Controlled Trials as Topic
/
Nerve Block
Limits:
Aged
/
Aged80
/
Humans
Language:
En
Journal:
Int J Orthop Trauma Nurs
/
International journal of orthopaedic and trauma nursing (Online)
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: