Erector spinae plane versus fascia iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block

Flaviano, Edoardo; Bettinelli, Silvia; Assandri, M; Muhammad, H; Benigni, Alberto; Cappelleri, G; Mariano, Edward R.; Lorini, Luca; Bugada, Dario

doi:10.4097/kja.22669

Cited by 9 publications

(5 citation statements)

References 37 publications

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“…Chronic back pain, instability, neurogenic claudication, as well as radicular symptoms can appear due to its connection with spinal stenosis of lumbar secondary to LDS resulting in nerve root compression. [ 12 , 13 ] Since various treatment modalities have been used recently, there has been a long debate over the treatment of LDS. [ 14 ] In few previous studies, there have been outcome comparison between SM and NSM in patients with LDS.…”

Section: Discussionmentioning

confidence: 99%

Surgical versus nonsurgical management of lumbar degenerative spondylolisthesis based on spinal canal cross-sectional area

Cho,

Kang,

Lee

et al. 2024

Medicine

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Disability and pain associated with lumbar degenerative spondylolisthesis (LDS) result in a significant burden on both the healthcare costs and patients’ quality of life. Currently, there exists controversy regarding employment of either nonsurgical management (NSM) or surgical management (SM) in a clinical setting. Spinal canal cross-sectional area (SCA) has been an important morphological parameter for the analysis of LDS. However, there is lack of research about the comparative value of NSM and SM according to SCA. Moreover, previous research have not yet evaluated the clinical most suitable cutoff values of SCA. The objective of this research was to evaluate the effective of NSM and SM for LDS using SCA as an objective morphological parameter. The axial T2 magnetic resonance imaging images were obtained from each patient. We collected SCA samples from 149 patients with LDS. 72 patients underwent SM and the rest did NSM. We measured SCA at the L4/5 LDS on magnetic resonance imaging using a picture archiving and communications system. We measured SCA at the intervertebral disk posterior border, turning down to reach the facet joint side on the opposite edge at the L4/5 level. The average SCA value was 114.34 ± 48.11 mm2 in the NSM group and 69.88 ± 27.87 mm2 in the SM group. Therefore, the SM group had considerably lower SCA (P < .001). In view of the effectiveness of SCA as a prediction factor of surgical option, Receiver Operating Characteristic curve analysis show the optimal cutoff value for SCA as 83.21 mm2, with 70.8% sensitivity, 71.4% specificity, and an area under the curve of 0.80 (95% CI, 0.73–0.87). The narrower the SCA, the higher the probability of SM. Thus, it is proposed that to evaluate surgical decision making, the pain physician should carefully inspect the SCA.

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Section: Discussionmentioning

confidence: 99%

Surgical versus nonsurgical management of lumbar degenerative spondylolisthesis based on spinal canal cross-sectional area

Cho,

Kang,

Lee

et al. 2024

Medicine

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“…To our knowledge, few studies have compared L-ESPB and FICB in total hip replacement surgeries. Flaviano et al [15] concluded that Both L-ESPB and FICB have comparable advantages in reducing the need for opioids during the initial 24 hours following surgeries. Nevertheless, L-ESPB leads to less deterioration in the quadriceps motor function.…”

Section: Discussionmentioning

confidence: 99%

Comparative study between ultrasound-guided lumbar erector spinae plane block and fascia iliaca compartment block for postoperative analgesia after total hip arthroplasty

Zahran,

El-Sheikh,

Elbadry

et al. 2024

Int. J. Med. Anesthesiology

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Background: Optimized pain therapy following total hip arthroplasty (THA) is associated with important benefits, including more rapid rehabilitation and decreased risk of postoperative consequences. The purpose of this work was to contrast the pain-relieving effectiveness of ultrasoundguided Lumbar Erector Spinae Plane block (L-ESPB) against Fascia Iliaca Compartment Block (FICB) among individuals who were going to have THA. Methods: This randomised controlled double-blinded work had been conducted on 75 participants aged from 30 to 75 years old, both genders, I-III physical status based on American Society of Anesthesiologists, scheduled for unilateral hip replacement surgeries utilising spinal anaesthesia. Patients were categorised into three equal groups. Patients obtained spinal anaesthesia alone in the control group plus ipsilateral L-ESPB (30 ml of bupivacaine 0. 25%) in the L-ESPB group and ipsilateral suprainguinal FICB (30 ml of bupivacaine 0. 25%) in the FICB group. Blocks had been conducted at the end of the surgeries guided by ultrasound. Results:The time of first analgesic request revealed a significant delay in both L-ESPB group and FICB group as contrasted to the control group without significant variation among them. A significant increase in total 24-hour postoperative rescue morphine consumption and numerical rating scale in the control group had been existed contrasted to L-ESPB and FICB groups at 4hrs, 8hrs, 12hrs, 18hrs, and 24hrs (p<0.05) without significant variation among them. No patient in the three groups experienced any adverse effect in terms of infection, local anesthetic toxicity, or hematoma. Conclusion:In patients undergoing THA, both L-ESPB and FICB are safe and comparable when used for postoperative analgesia.

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“…Contrast material spread to the paravertebral, foraminal, and partially epidural area/spaces and in the areas where the lumbar nerves enter the psoas muscle which may hint at the mechanism of analgesia of the block [ 38 ]. The lumbar ESP block has shown similar analgesia to the infra-inguinal fascial iliaca block after elective hip arthroplasty with the potential for motor sparing of the quadriceps muscle [ 39 ]. A recent meta-analysis concluded that the use of the lumbar ESP block resulted in reduced opioid consumption in the first 24 h after surgery with significantly lower pain scores in the first 8 h after surgery [ 40 ].…”

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

Peripheral Nerve Blocks for Hip Fractures

Muse,

Deiling,

Grinman

et al. 2024

JCM

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The incidence of hip fractures has continued to increase as life expectancy increases. Hip fracture is one of the leading causes of increased morbidity and mortality in the geriatric population. Early surgical treatment (<48 h) is often recommended to reduce morbidity/mortality. In addition, adequate pain management is crucial to optimize functional recovery and early mobilization. Pain management often consists of multimodal therapy which includes non-opioids, opioids, and regional anesthesia techniques. In this review, we describe the anatomical innervation of the hip joint and summarize the commonly used peripheral nerve blocks to provide pain relief for hip fractures. We also outline literature evidence that shows each block’s efficacy in providing adequate pain relief. The recent discovery of a nerve block that may provide adequate sensory blockade of the posterior capsule of the hip is also described. Finally, we report a surgeon’s perspective on nerve blocks for hip fractures.

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Erector spinae plane versus fascia iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block

Abstract: This article has been accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination, and proofreading processes, which may lead to differences between this version and the version of record.

Cited by 9 publications

References 37 publications

Surgical versus nonsurgical management of lumbar degenerative spondylolisthesis based on spinal canal cross-sectional area

Surgical versus nonsurgical management of lumbar degenerative spondylolisthesis based on spinal canal cross-sectional area

Comparative study between ultrasound-guided lumbar erector spinae plane block and fascia iliaca compartment block for postoperative analgesia after total hip arthroplasty

Peripheral Nerve Blocks for Hip Fractures

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