Ultrasound-guided suprainguinal fascia iliaca compartment block and early postoperative analgesia after total hip arthroplasty: a randomised controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(2):7 Br J Anaesth . 2024 Jul;133(1):146-151.What this means for my practice?
Ultrasound-guided suprainguinal fascia iliaca block did not significantly reduce opioid consumption or improve pain control compared to a sham block in patients undergoing total hip arthroplasty under spinal anesthesia. This suggests that routine use of this block may not be necessary in the context of a robust multimodal analgesic regimen. One limitation of the study is that it did not assess the success rate of the nerve block, which could have influenced the results.
Study Summary
One hundred thirty-four patients undergoing elective primary total hip arthroplasty under spinal anesthesia were randomized to receive either an ultrasound-guided suprainguinal fascia iliaca compartment block with 0.5% ropivacaine (n=66) or a sham block with normal saline (n=67). The primary outcome was opioid consumption in the first 24 hours postoperatively. Secondary outcomes included pain scores at 4, 8, 12, 16, 20, and 24 hours postoperatively, opioid-related side effects (nausea, vomiting, pruritus), ability to perform physiotherapy on postoperative day one, and presence of physiotherapist-assessed quadriceps weakness. Overall, the study found no significant difference in opioid consumption between groups or in secondary outcomes, including pain scores, opioid-related side effects, or ability to perform physiotherapy. These findings suggest that adding ultrasound-guided suprainguinal fascia iliaca block to a multimodal analgesic regimen does not provide a significant opioid-sparing benefit after total hip arthroplasty.
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