Comparison of the postoperative analgesic efficacy of an ultrasound-guided fascia iliaca compartment block versus 3 in 1 block in hip prosthesis surgery

Deniz, Süleyman; Atım, Abdülkadir; Kürklü, Mustafa; Çaycı, Tuncer; Kurt, Ercan

doi:10.5505/agri.2014.76993

Cited by 40 publications

(55 citation statements)

References 16 publications

(32 reference statements)

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“…All patients received general anesthesia for surgery. Four articles [11–14] reported that TJAs were performed by same teams. Three studies [11,13,15] received premedication for pain relief.…”

Section: Resultsmentioning

confidence: 99%

“…[11–14] A fixed-effects model was used because no significant heterogeneity was found among these studies ( χ 2 = 0.56, df = 3, I 2 = 0%, P = .906). The pooled results demonstrated that there was no significant difference in opioids consumption at 24 hours between groups (SMD = 0.037, 95% CI: −0.212 to 0.286, P = .771; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Four articles [11–14] reported the outcomes of opioids consumption at 48 hours after TJA. A fixed-effects model was used because no significant heterogeneity was found among the pooled data ( χ 2 = 0.61, df = 3, I 2 = 0%, P = .893).…”

Section: Resultsmentioning

confidence: 99%

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Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty

et al. 2017

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Background:This meta-analysis aimed to perform a meta-analysis to compare the efficiency and safety between femoral nerve block (FNB) and fascia iliaca block (FIB) for postoperative pain control in patients undergoing total knee and hip arthroplasties.Methods:A systematic search was performed in Medline (1966-2017.05), PubMed (1966-2017.05), Embase (1980-2017.05), ScienceDirect (1985-2017.05) and the Cochrane Library. Inclusion criteria (1) Participants: Only published articles enrolling adult participants that with a diagnosis of end-stage of osteoarthritis and prepared for unilateral TKA or THA; (2) Interventions: The intervention group received FIB for postoperative pain management; (3) Comparisons: The control group was received FNB for postoperative pain control; (4) Outcomes: Visual analogue scale (VAS) scores in different periods, opioids consumption, length of stay and postoperative complications; (5) Study design: clinical randomized control trials (RCTs) were regarded as eligible in our study. Cochrane Hand book for Systematic Reviews of Interventions was used for assessment of the included studies and risk of bias was shown. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Sensitivity analysis was conducted and publication bias was assessed. Meta-analysis was performed using Stata 11.0 software.Results:Five RCTs including 308 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of visual analog scale (VAS) score at 12 hours (SMD = −0.080, 95% CI: −0.306 to 0.145, P = .485), 24 hours (SMD = 0.098, 95% CI: −0.127 to 0.323, P = .393), and 48 hours (SMD = −0.001, 95% CI: −0.227 to 0.225, P = .993). No significant differences were found regarding opioid consumption at 12 hours (SMD = 0.026, 95% CI: −0.224 to 0.275, P = .840), 24 hours (SMD = 0.037, 95% CI: −0.212 to 0.286, P = .771), and 48 hours (SMD = −0.016, 95% CI: −0.265 to 0.233, P = .900). In addition, no significant increase of complications was identified between groups.Conclusion:There is no significant differences of VAS scores at 12-48 hour and opioids consumption at 12-48 hour between two groups following total joint arthroplasty. No increased risk of nausea, vomiting and pruritus was observed in both groups. More high-quality large RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of FNB with FIB. The present meta-analysis exists some limitations that should be noted: (1) Only five articles were included in present meta-analysis, although all of them are recently published RCTs, the sample size are relatively small; (2) Functional outcome is an important parameter, due to the insufficiency of relevant data, we cannot perform a meta-analysis. (3) Dose and types of local anesthetics are varied, which may influence the results; (4) The duration of follow up is relatively short which leads to underestimating complications. (5) Publication bias in present meta-analysis ...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty

et al. 2017

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“…[1,2] However, as the FICB was performed under real-time ultrasound guidance, the success rate was increased to 82% to 87%, leading to an increased interest in FICB as a postoperative analgesia option for hip and knee surgical procedures. [2,3] …”

Section: Introductionmentioning

confidence: 99%

Efficacy of ultrasound-guided fascia iliaca compartment block after hip hemiarthroplasty

Bang

Chung²,

Jeong³

et al. 2016

Medicine

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Background:The fascia iliaca compartment block (FICB) provides an analgesic effect in patients with femur fractures. However, the postoperative pain after hip surgery is different from that after femur fracture, because of the difference in the degree and location of tissue trauma. Whether FICB provides effective postoperative analgesia in patients undergoing total hip arthroplasty is not well understood. Moreover, there is no prospective randomized study to evaluate FICB as a postoperative analgesia in hemiarthroplasty. Therefore, we performed a randomized and prospective study to determine the effect of FICB after hemiarthroplasty. The objective of this study was to compare the opioid consumption between patients who received intravenous patient-controlled analgesia (PCA) with and without FICB.Methods:Twenty-two patients aged 70 to 90 years who underwent bipolar hemiarthroplasty for femoral neck fracture were recruited and allocated randomly into 2 groups: FICB group (n = 11) and Non-FICB group (n = 11). All patients received spinal anesthesia with 10 mg of 0.5% hyperbaric bupivacaine. After surgery, the FICB was conducted using a modified technique with 0.2% ropivacaine (40 mL) under ultrasonographic guidance, and the intravenous PCA was administered to patients in both groups in the separate block room. The PCA was set up in the only bolus mode with no continuous infusion. The visual analog scale (VAS) and the opioid consumption were noted at 4, 8, 12, 24, and 48 hours postoperatively.Results:The VAS was similar in both groups. The fentanyl requirement at 4, 8, and 12 hours was low in the FICB group. The total amount of fentanyl required in the first 24 hours was 246.3 μg in the FICB group and 351.4 μg in the Non-FICB group. No patient developed any residual sensory-motor deficit during the postoperative period. Patients in the Non-FICB group had nausea (n = 2), and pruritus (n = 1), and 1 patient had nausea in the FICB group during postoperative 2 days.Conclusion:The FICB has a significant opioid-sparing effect in first 24 hours after hemiarthroplasty. This suggests that FICB is an effective way for multimodal analgesia in hip surgery.

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“…The sensorial innervation of the hip is provided by the nerves in the lumbar plexus and sacral plexus (42). Although whether lumbar or sacral plexus have a primary effect on sensorial innervation of the hip remains unknown, according some previous studies (39,40) and the present study, the lumbar plexus block can provide effective analgesia.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound‑guided continuous fascia iliaca compartment block for pre‑operative pain control in very elderly patients with hip fracture: A randomized controlled trial

Xue

et al. 2018

Exp Ther Med

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The present study presented the results of a prospective, randomized controlled trial. The present study enrolled 98 very elderly patients with hip fractures, complicated with at least one cardiovascular, neurological or pulmonary disease, of whom 10 patients were excluded. A total of 88 patients were randomly assigned into 2 groups: i) The control group, receiving traditional analgesia including 50 mg Tramadol and 500 mg paracetamol orally three times a day from admission to surgery; and ii) the study group, receiving ultrasound-guided continuous fascia iliaca compartment block (CFICB), a single 50 ml 0.4% ropivacaine injection with continuous infusion of 0.2% ropivacaine at a dose of 5 ml/h from admission to surgery. The primary outcome measure of pain relief or pain intensity was assessed preoperatively and up to 48 h postoperatively using a visual analog scale (VAS). The results of the present study indicated that in the preoperative period, in the morning of the day of surgery, the VAS pain at rest scores were lower in the study group compared with the control group (P=0.023). The VAS passive movement scores of the study group were also significantly lower compared with the control group 1 h following analgesia at the time of admission (P<0.05) and in the morning of the day of surgery (P<0.05). Scores for patients' satisfaction with the analgesic regimen in the preoperative period were greater in the study group compared with the control group (P<0.001). There was no difference in analgesia-associated side effects between groups. Duration of hospital stay of patients in the control group was significantly longer compared with the study group (P=0.001). Patients in the study group were less likely to have increased complications compared with patients in the control group over the N2-N4 period (from preoperative period to after surgery; P=0.016). The present study concluded that ultrasound guided CFICB was an effective method of providing analgesia for very elderly (≥80 years old) with hip fracture.

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Comparison of the postoperative analgesic efficacy of an ultrasound-guided fascia iliaca compartment block versus 3 in 1 block in hip prosthesis surgery

Abstract: We believe that the safe and efficient application of the ultrasound-guided 3 in 1 block and the FICB is necessary in multimodal analgesic treatment in order to enable postoperative analgesia in hip prosthesis surgery.

Cited by 40 publications

References 16 publications

Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty

Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty

Efficacy of ultrasound-guided fascia iliaca compartment block after hip hemiarthroplasty

Ultrasound‑guided continuous fascia iliaca compartment block for pre‑operative pain control in very elderly patients with hip fracture: A randomized controlled trial

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