Circum-Psoas Block versus Supra-Inguinal Fascia Iliaca Block for Postoperative Analgesia in Patients Undergoing Total Hip Arthroplasty: A Randomized Clinical Trial.

研究概要

64 patients undergoing total hip arthroplasty were randomized to receive either a circum-psoas block (CPB; n=32) or a supra-inguinal fascia iliaca block (SIFIB; n=32). The primary outcome of interest was dynamic pain on a Visual Analog Scale (VAS) at 6 hours. Secondary outcomes of interest included dynamic pain at 12, 24, and 48 hours, pain at rest, time to first opioid request, opioid consumption, number of affected dermatomes, motor block in knee extension, hip flexion, and ankle flexion, incidence of adverse events, length of stay, and patient satisfaction. Patients in the CPB group had significantly lower dynamic pain at 6, 12, and 24 hours compared to the SIFIB group. Pain at rest at 6 and 12 hours, time to first opioid request, total opioid consumption, knee extension (6 & 12h), hip flexion (6, 12, & 24h) and dermatomal coverage (6, 12, & 24h) were all significantly better in the CPB group. All other outcomes were similar between the two groups. CPB can offer better pain relief, lower opioid consumption, improved muscle strength, and better blockade after total hip arthroplasty over SIFIB.