Changes in the tumor necrosis factor-α level after an ultrasound-guided femoral nerve block in elderly patients with a hip fracture
Abstract Background and objectives: An ultrasound guided femoral nerve block is an established analgesic method in patients with a hip fracture. Elevated cytokine levels correlate with poor patient outcomes after surgery. Hence, the aim of the study was to describe the levels of tumor necrosis fact...
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Sociedade Brasileira de Anestesiologia
2018-11-01
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| Series: | Revista Brasileira de Anestesiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000600558&tlng=pt |
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| author | Ji Su Jang Yeon-Hee Lee Hemant K. Kandahar Suman K. Shrestha Jae Sung Lee Jin-Koo Lee Seung Jae Park Na Rea Lee Jae Jun Lee Sang-Soo Lee |
| author_facet | Ji Su Jang Yeon-Hee Lee Hemant K. Kandahar Suman K. Shrestha Jae Sung Lee Jin-Koo Lee Seung Jae Park Na Rea Lee Jae Jun Lee Sang-Soo Lee |
| author_sort | Ji Su Jang |
| collection | DOAJ |
| description | Abstract Background and objectives: An ultrasound guided femoral nerve block is an established analgesic method in patients with a hip fracture. Elevated cytokine levels correlate with poor patient outcomes after surgery. Hence, the aim of the study was to describe the levels of tumor necrosis factor-α after an ultrasound-guided femoral nerve block in elderly patients having a femoral neck fracture. Methods: A total of 32 patients were allocated into two treatment groups: 16 patients (femoral nerve block group; ultrasound-guided femoral nerve block with up to 20 mL of 0.3 mL.kg−1 of 0.5% bupivacaine and intravenous tramadol) and 16 patients (standard management group; up to 3 mL of 0.9% saline in the femoral sheath and intravenous tramadol). Tumor necrosis factor-α and visual analogue scale scores were evaluated immediately before the femoral nerve block and again at 4, 24, and 48 h after the femoral nerve block. All surgery was performed electively after 48 h of femoral nerve block. Results: The femoral nerve block group had a significantly lower mean tumor necrosis factor-α level at 24 (4.60 vs. 8.14, p < 0.001) and 48 h (5.05 vs. 8.56, p < 0.001) after the femoral nerve block, compared to the standard management group. The femoral nerve block group showed a significantly lower mean visual analogue scale score at 4 (3.63 vs. 7.06, p < 0.001) and 24 h (4.50 vs. 5.75, p < 0.001) after the femoral nerve block, compared to the standard management group. Conclusions: Ultrasound-guided femoral nerve block using 0.3 mL.kg−1 of 0.5% bupivacaine up to a maximum of 20 mL resulted in a significant lower tumor necrosis factor-α level. |
| first_indexed | 2024-12-20T09:25:48Z |
| format | Article |
| id | doaj.art-38c50af6392145d387dfea422407b39d |
| institution | Directory Open Access Journal |
| issn | 1806-907X |
| language | English |
| last_indexed | 2024-12-20T09:25:48Z |
| publishDate | 2018-11-01 |
| publisher | Sociedade Brasileira de Anestesiologia |
| record_format | Article |
| series | Revista Brasileira de Anestesiologia |
| spelling | doaj.art-38c50af6392145d387dfea422407b39d2022-12-21T19:45:11ZengSociedade Brasileira de AnestesiologiaRevista Brasileira de Anestesiologia1806-907X2018-11-0168655856310.1016/j.bjane.2018.04.002Changes in the tumor necrosis factor-α level after an ultrasound-guided femoral nerve block in elderly patients with a hip fractureJi Su JangYeon-Hee LeeHemant K. KandaharSuman K. ShresthaJae Sung LeeJin-Koo LeeSeung Jae ParkNa Rea LeeJae Jun LeeSang-Soo LeeAbstract Background and objectives: An ultrasound guided femoral nerve block is an established analgesic method in patients with a hip fracture. Elevated cytokine levels correlate with poor patient outcomes after surgery. Hence, the aim of the study was to describe the levels of tumor necrosis factor-α after an ultrasound-guided femoral nerve block in elderly patients having a femoral neck fracture. Methods: A total of 32 patients were allocated into two treatment groups: 16 patients (femoral nerve block group; ultrasound-guided femoral nerve block with up to 20 mL of 0.3 mL.kg−1 of 0.5% bupivacaine and intravenous tramadol) and 16 patients (standard management group; up to 3 mL of 0.9% saline in the femoral sheath and intravenous tramadol). Tumor necrosis factor-α and visual analogue scale scores were evaluated immediately before the femoral nerve block and again at 4, 24, and 48 h after the femoral nerve block. All surgery was performed electively after 48 h of femoral nerve block. Results: The femoral nerve block group had a significantly lower mean tumor necrosis factor-α level at 24 (4.60 vs. 8.14, p < 0.001) and 48 h (5.05 vs. 8.56, p < 0.001) after the femoral nerve block, compared to the standard management group. The femoral nerve block group showed a significantly lower mean visual analogue scale score at 4 (3.63 vs. 7.06, p < 0.001) and 24 h (4.50 vs. 5.75, p < 0.001) after the femoral nerve block, compared to the standard management group. Conclusions: Ultrasound-guided femoral nerve block using 0.3 mL.kg−1 of 0.5% bupivacaine up to a maximum of 20 mL resulted in a significant lower tumor necrosis factor-α level.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000600558&tlng=ptCytokinesFemoral nerveHip fractureInflammatory responseTumor necrosis factor alpha |
| spellingShingle | Ji Su Jang Yeon-Hee Lee Hemant K. Kandahar Suman K. Shrestha Jae Sung Lee Jin-Koo Lee Seung Jae Park Na Rea Lee Jae Jun Lee Sang-Soo Lee Changes in the tumor necrosis factor-α level after an ultrasound-guided femoral nerve block in elderly patients with a hip fracture Revista Brasileira de Anestesiologia Cytokines Femoral nerve Hip fracture Inflammatory response Tumor necrosis factor alpha |
| title | Changes in the tumor necrosis factor-α level after an ultrasound-guided femoral nerve block in elderly patients with a hip fracture |
| title_full | Changes in the tumor necrosis factor-α level after an ultrasound-guided femoral nerve block in elderly patients with a hip fracture |
| title_fullStr | Changes in the tumor necrosis factor-α level after an ultrasound-guided femoral nerve block in elderly patients with a hip fracture |
| title_full_unstemmed | Changes in the tumor necrosis factor-α level after an ultrasound-guided femoral nerve block in elderly patients with a hip fracture |
| title_short | Changes in the tumor necrosis factor-α level after an ultrasound-guided femoral nerve block in elderly patients with a hip fracture |
| title_sort | changes in the tumor necrosis factor α level after an ultrasound guided femoral nerve block in elderly patients with a hip fracture |
| topic | Cytokines Femoral nerve Hip fracture Inflammatory response Tumor necrosis factor alpha |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000600558&tlng=pt |
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