Objective To investigate analgesic effects of ultrasound-guided fascia iliaca compartment block (FICB ) for patients undergoing total hip arthroplasty (THA). Methods Between March 2014 and October 2014,a total of 60 ASA Ⅰ -Ⅱpatients were randomly assigned into 2 groups:fascia iliaca compartment block group (group F,n =30)or psoas compartment block group (group P,n =29;one patient quitted the study due to suspected epidural diffusion).All the patients were injected 35 ml 0.4%ropivacaine before general anesthesia and received patient controlled analgesia (PCA)after surgery for 48 hours.The visual analogue scale (VAS)of postoperative pain (0 -100 points),the demands of PCA and the area of sensory blockade were assessed during 0 -4,4 -8,8 -12,12 -24,24 -36,36 -48 h after nerve block,respectively.The time to initiation of PCA,as well as incidences of complications including nausea,vomiting,respiratory inhibition,pruritus,urinary retention and nerve injury,were also recorded throughout this study. Results Demands of PCA during 0 -12 h in the P group (median:12,P10 -P90 :8 -18)were significantly lower than those in F group (15,10 -20)(Z =-2.370,P =0.018),while in the period of 12 -24 h,demands of PCA in the F group (4,3 -5 )were significantly lower than those in the P group (6,5 -8 )(Z = -4.649,P =0.000 ).The VAS of FICB administration were significantly lower than those of PCB [30 (25,40)points vs.50 (40,60)points,Z =-6.397,P =0.000]. There were no statistically significant differences in other parameters between the two groups. Conclusions Ultrasound-guided FICB can provide similar pain relief for total hip arthroplasty as compared with PCB.The FICB is more acceptable for its simplicity,safety and painlessness.%目的：探讨全髋关节置换术后髂筋膜间隙阻滞（fascia iliaca compartment block，FICB）的镇痛效果。方法2014年3～10月，选择60例单侧全髋关节置换术患者随机分为 FICB 组和腰大肌间隙阻滞（psoas compartment block，PCB）组。PCB 组1例疑似出现硬膜外扩撒中途退出，PCB 组29例，FICB 组30例。全麻前分别行髂筋膜或腰大肌间隙阻滞，给予0．4％罗哌卡因35 ml。术后采用持续静脉患者自控镇痛（patient controlled analgesia，PCA）至术后48 h。记录阻滞完成后0～4，4～8，8～12，12～24，24～36，36～48 h 静息状态下疼痛视觉模拟评分（visual analogue scales，VAS）（0～100分），追加 PCA 的次数及感觉阻滞范围，术后首次使用 PCA 时间，以及术后恶心呕吐、瘙痒、呼吸抑制、尿潴留和神经损伤的发生率。结果与PCB 组相比，FICB 组12 h 内 PCA 用量多[中位数15（P10＝10，P90＝20）次 vs．12（8，18）次，Z ＝－2．370，P ＝0．018]，12～24 h PCA 用量少[4（3，5）次 vs．6（5，8）次，Z ＝－4．649，P ＝0．000]。FICB 组操作时疼痛 VAS 评分明显小于 PCB 组[30（25，40）vs．50（40，60），Z ＝－6．397，P ＝0．000）]。其他指标差异均无统计学意义（P ＜0．05）。结论FICB 与 PCB 用于全髋关节置换术均可以取得良好的镇痛效果，但 FICB 操作简便、安全、迅速，患者更易接受。
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