Distal Injection Site May Explain Lack of Analgesia From Fascia Iliaca Block for Total Hip

Vaughan, Brian; Manley, Mark; Stewart, D.P.; Iyer, Vivek

doi:10.1097/aap.0000000000000011

Cited by 13 publications

(6 citation statements)

References 4 publications

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“…As such, we might expect a more consistent block of the targeted nerves, as they are topographically more closely related in their proximal course. 11 The results of our study confirm our hypothesis: the ON was blocked in 86% of the patients, and all 3 nerves were blocked in 67% of the patients. We also used a higher volume of LA (40 mL vs 30 mL) than Shariat et al used.…”

Section: Discussionsupporting

confidence: 88%

A Longitudinal Supra-Inguinal Fascia Iliaca Compartment Block Reduces Morphine Consumption After Total Hip Arthroplasty

Desmet

Vermeylen

Herreweghe

et al. 2017

Regional Anesthesia and Pain Medicine

150

137

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Section: Discussionsupporting

confidence: 88%

A Longitudinal Supra-Inguinal Fascia Iliaca Compartment Block Reduces Morphine Consumption After Total Hip Arthroplasty

Desmet

Vermeylen

Herreweghe

et al. 2017

Regional Anesthesia and Pain Medicine

150

137

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“…This is why the proximal spreading of local anesthetics was not achieved because the infrainguinal technique and transverse plane were used rather than the longitudinal plane. [22,23] …”

Section: Discussionmentioning

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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“…Since the initial publication of these methods, there has been controversy regarding the distribution of local anesthetic associated with their use and their ability to produce reliable ON block [3][4][5][6]. Despite these contentions, both the 3-in-1 and the FI compartment blocks continue to be tacitly validated in present-day literature [7][8][9]. To date, no studies of the 3-in-1 or FI compartment block have been performed using advanced imaging to document both exact needle position and accurate distribution of injectate.…”

Section: Introductionmentioning

confidence: 99%

Local anesthetic injection deep to the fascia iliaca at the level of the inguinal ligament: the pattern of distribution and effects on the obturator nerve

Swenson

Davis

Stream

et al. 2015

Journal of Clinical Anesthesia

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Distal Injection Site May Explain Lack of Analgesia From Fascia Iliaca Block for Total Hip

Cited by 13 publications

References 4 publications

A Longitudinal Supra-Inguinal Fascia Iliaca Compartment Block Reduces Morphine Consumption After Total Hip Arthroplasty

A Longitudinal Supra-Inguinal Fascia Iliaca Compartment Block Reduces Morphine Consumption After Total Hip Arthroplasty

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

Local anesthetic injection deep to the fascia iliaca at the level of the inguinal ligament: the pattern of distribution and effects on the obturator nerve

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