Iliopsoas plane block does not improve pain after primary total hip arthroplasty in the presence of multimodal analgesia: a single institution randomized controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(16):7 Reg Anesth Pain Med. 2025 Mar 5;50(3):257-263.What this means for my practice?
Clinicians should remember that iliopsoas plane block does not provide additional pain relief or recovery benefit in total hip arthroplasty patients already receiving multimodal analgesia. The key implication is that routine use of this block may not be justified in such contexts. However, the study’s limitations include the strong multimodal regimen (including buprenorphine and nefopam) and restriction to the posterior surgical approach, which may limit generalizability.
Study Summary
Fifty-six patients undergoing elective primary total hip arthroplasty were randomized to receive either a single-shot iliopsoas plane block with ropivacaine (n=28) or a sham saline injection (n=28). The primary outcome was numeric rating scale (NRS) pain score at rest 6 hours after surgery. Secondary outcomes included pain scores at rest and during movement at additional time points, opioid consumption, quadriceps strength, recovery milestones, quality of recovery, patient satisfaction, and adverse events. Outcomes were assessed up to 48 hours postoperatively. Overall, the results revealed no significant differences in pain, opioid use, muscle strength, or recovery parameters between the groups. The findings suggest that iliopsoas plane block does not provide additional analgesic benefit beyond multimodal analgesia in this setting.
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