Abstract: Objective To systematically review the analgesic efficacy of fascia iliaca compartment block(FICB) during positioning before intrathecal anesthesia in patients with femur fractures. Methods Databases including PubMed, Cochrane Library (Issue9, 2017), Embase, Wanfang Database, CNKI, VIP and SinoMed were searched to collect randomized controlled trial (RCT) about FICB versus opioid analgesics for pain control during changes of position in patients with femur fracture from inception to October 2017. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then Meta-analysis was performed using RevMan 5.3 software. Results A total of 8 RCT studies involving 431 patients were included. The results of Meta-analysis showed that, compared with opioid analgesics, FICB could shorten the pain score during positioning before intrathecal anesthesia[standardized mean difference(SMD)=-2.37, 95%CI(-2.89, -1.86), P<0.01], the time to perform intrathecal anesthesia [SMD=-1.13, 95%CI(-1.39, -0.88), P<0.01], and the incidence of FICB complications were significantly lower than opioid analgesics[relative risk(RR)=0.10, 95%CI(0.02, 0.39), P<0.01]. Conclusions Compared with opioid analgesics, FICB can relieve the pain during positioning before intrathecal anesthesia and shorten the time to perform intrathecal anesthesia, with less complications.
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