Fascia iliaca compartment block versus no block for pain control after lower limb surgery: a meta-analysis

Abstract

BackgroundThe analgesic effect of fascia iliaca compartment block (FICB) versus no block (NB) after lower limb surgery (LLS) is still controversial, so we performed this meta-analysis.Materials and methodsBy searching the PubMed, Embase and the Cochrane Library (last update by July 20, 2017), randomized controlled trials comparing the analgesic effect of FICB versus NB in patients receiving LLS were identified. The primary outcome was the pain scores at 4, 12, and 24 h after LLS. The dosage of morphine at 24 h was also collected. The side effect of anesthesia was assessed according to the occurrence rate of postoperative nausea and vomiting.ResultsData from 7 clinical trials that included 508 patients were summarized. The results showed that patients receiving FICB had lower pain scores at 4 h (mean difference [MD]=−1.17; 95% CI=−2.30 to −0.05; P=0.041), 12 h (MD=−0.41; 95% CI=−0.76 to −0.05; P=0.026) and 24 h (MD=−0.96; 95% CI=−1.77 to −0.15; P=0.020) after LLS. Besides, FICB could reduce the dosage of morphine at 24 h (MD=−2.06; 95% CI=−3.82 to −0.30; P=0.022) and the incidence of postoperative nausea and vomiting (relative risk rate=0.44, 95% CI=0.24–0.80, P=0.008).ConclusionCompared with NB, FICB is an effective and safe method for alleviating the pain after LLS. More high-quality randomized controlled trials are needed to confirm this finding.

The efficacy of fascia iliaca compartment block for pain control after hip fracture

“…[22] We identified VAS after hip fracture as outcomes, results shown that FICB has a beneficial role in reducing pain intensity up to 48 h. There was no significant difference between 72 h after hip fracture. Yang L et al [23] conducted a meta-analysis about FICB versus no block for pain control in lower limb surgery. Results shown that, FICB is an effective and safe method for alleviating the pain in lower limb surgery.…”

Inadvertent quadriceps weakness following the pericapsular nerve group (PENG) block

“…Hydrolocation by injecting small volumes (1–2 mL) of local anesthetic or other fluid, such as normal saline, can aid in identifying the needle tip location during this block 2. The fascia iliaca and femoral nerve are located superficial to the structures of interest in the PENG block, as shown in figure 1A,B 3. Thus, superficial injection of local anesthetic while performing the PENG block may result in an inadvertent fascia iliaca block or femoral nerve block, which could explain the presence of quadriceps weakness postoperatively in our first case 3…”

A Comparative Study on the Effects of Pre-Operative Fascia Iliaca Plane Block on Hip Surgeries Done Under Spinal Anaesthesia in Elderly Patients, vs. No Block on Post Operative Pain Scores

“…Yang L et al in Journal of pain research compared FICB vs no block the pain score was less in 4, 12, and 24 hours with reduced requirement of morphine and as a consequence less nausea and vomiting. 10 The pop technique had lower rate of success 35-45% compared to real time us guided blocks which has more than 80% success rate. Seunguk Bang MD et al in 22 patients aged 70-90 yrs.…”