2022 AAOS Annual Meeting: Prospective randomized study comparing suprainguinal fascia iliaca block vs. pericapsular nerve group block vs. local anesthetic infiltration vs. spinal anesthetic without adjuncts for pain control following total hip arthroplasty

One hundred and thirty-nine patients with hip osteoarthritis were randomized to receive either a suprainguinal fascia iliaca compartment block (n=35), pericapsular nerve group block (n=35), local anesthetic infiltration (n=33), or spinal anesthetic without adjuncts (n=36). The primary outcome of interest was cumulative opioid consumption at 24 hours postoperatively. Secondary outcomes of interest included pain scores, patient satisfaction with pain control, length of hospital stay, and complications. Outcomes were assessed at four, 24, and 48 hours postoperatively, as well as at two and four days. Overall, the results of the study revealed that all adjunct groups had significantly lower opioid consumption compared to the control group at 24 hours postoperatively. Patients in the local anesthetic infiltration group also reported lower pain scores at 4 hours and showed a trend towards better satisfaction with pain control. These findings suggest that local anesthetic infiltration may be a preferred adjunct due to its ease of intraoperative application and effectiveness.