Systematic review and meta-analysis of single injection fascia iliaca blocks in the peri-operative management of patients with hip fractures

Fadhlillah, Fiqry; Chan, David; Pelosi, Paolo; Rubulotta, Francesca

doi:10.23736/s0375-9393.19.13535-3

Cited by 7 publications

(4 citation statements)

References 34 publications

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“…Both the FICB and the FNB have been shown to reduce pain scores and opioid consumption. Our findings on FNB and FICB confirm previous systematic reviews and meta-analyses, which conclude that either FNB or FICB are safe and effective to provide good perioperative analgesia and to reduce the total amount of opioid consumption [70][71][72][73][74][75][76][77][78] . Typically, peripheral nerve blocks can reduce pain on movement within 30 minutes of block placement and effect size is proportional to the concentration of local anaesthetic used 70 .…”

Section: Discussionsupporting

confidence: 88%

Pain management after hip fracture repair surgery: a systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations

Pissens,

Cavens,

Joshi

et al. 2024

Acta Anaest Belg

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Hip fracture is associated with moderate-to-severe postoperative pain, which can influence postoperative recovery and length of stay. The aim of this systematic review was to update the available literature and develop recommendations for optimal pain management after hip fracture. A systematic review utilising procedure specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials, systematic reviews and meta-analysis published in the English language between 04 April 2005 and 12 May 2021, evaluating the effects of analgesic, anaesthetic and surgical interventions were retrieved from MEDLINE, Embase and Cochrane Databases. A total of 60 studies met the inclusion criteria. For patients having hip fracture, pre, intra and postoperative paracetamol and non-steroidal anti-inflammatory drugs or COX-2 inhibitors are recommended. A single shot femoral nerve block or a single shot fascia iliaca compartment block are recommended. Continuous catheter techniques should be used only in specific circumstances. The choice between femoral nerve block or a fascia iliaca compartment block should be made according to local expertise. The postoperative regimen should include regular paracetamol, non-steroidal anti-inflammatory drugs and COX-2 inhibitors with opioids used for rescue. Some of the interventions, although effective, carry risks, and consequentially were omitted from the recommendations, while other interventions were not recommended due to insufficient, inconsistent or lack of evidence.

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Section: Discussionsupporting

confidence: 88%

Pain management after hip fracture repair surgery: a systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations

Pissens,

Cavens,

Joshi

et al. 2024

Acta Anaest Belg

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“…The effective analgesic duration of FICB can be up to 36-48 h. However, it has been found that FICB cannot completely block the obturator nerve, so there is often a problem of insufficient analgesia [14][15][16][17] . Cui et al 18 showed that both FICB and PNGB could well relieve the acute early pain of elderly patients with hip fractures, but PNGB took effect quickly and had a better analgesic effect.…”

Section: Discussionmentioning

confidence: 99%

Analgesic effect of pericapsular nerve group block on elderly patients undergoing hip replacement

Zhou¹,

Xu²,

Zuo³

et al. 2023

VOJNOSANIT PREGL

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Background/Aim. Pericapsular nerve group block (PNGB) does not affect the motor nerve while blocking obturator and femoral nerves. The aim of study was to determine the application value of PNGB for elderly hip replacement. Methods. Ninety elderly patients undergoing hip replacement from March 2019 to October 2020 were randomly divided into fascia iliaca compartment block (FICB) and PNGB groups. FICB and PNGB were performed prior to subarachnoid block (SAB), respectively. Their baseline data, operation conditions, incidence of adverse reactions, visual analogue scale (VAS) score, heart rate (HR), mean arterial pressure (MAP), plasma cortisol (COR) and epinephrine (E) were compared. Results. VAS score, E and COR levels in PNGB group were lower than those in FICB group at time points T2-T4 (T2: 10 min after nerve block; T3: at position changing; T4: after position changing) (p<0.001). There were no significant differences in HR and MAP between the two groups at any time point (p >0.05). In PNGB group, the ultrasonic imaging time was shorter, the time point of pressing patient-controlled analgesia (PCA) for the first time was later, and the numbers of pressing PCA were fewer than those of FICB group (p <0.001). No local anesthetic poisoning occurred after nerve block, and no hematoma at the puncture site, nerve injury, nausea and vomiting, dizziness and delirium were found.Conclusion. Both FICB and PNGB prior to Swere highly safe for elderly hip replacement, but PNGB has shorter ultrasonic imaging time, better analgesic effect and milder oxidative stress, so it is worth applicating it clinically.

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“…As expected, preoperative regional analgesia provided significantly better pain relief to systemic analgesia alone, especially when dealing with pain on movement. [26][27][28][29] .…”

Section: Pain Reliefmentioning

confidence: 99%

Peripheral Nerve Blocks for Hip Fractures in Emergency Medicine

Simić

Adam

Rošić

et al. 2022

ACC

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Hip fractures represent a major public health issue with increasing incidence as a population ages. The aim of this review is to describe peripheral nerve block techniques (the fascia iliaca compartment block and the pericapsular nerve group block) as pain management for hip fractures in emergency medicine, and to emphasize their benefits. Hip fractures are extremely painful injuries. The pain itself is unpleasant for patients and if left untreated it can lead to multiple complications during preoperative, operative and postoperative patient management. Pain management for elderly hip fracture patients is often challenging. Non-steroidal anti-inflammatory drugs are not recommended due to their side effects, the increased risk of gastrointestinal bleeding, renal function impairment and platelet aggregation inhibition. Paracetamol alone is often insufficient, and opioids have many potentially harmful side effects, such as delirium development. Peripheral nerve blocks for hip fractures are safe and effective, also in emergency medicine settings. The benefits for patients are greater pain relief, especially during movement, less opioid requirements and decreased incidence of delirium. Regional analgesia should be routinely used in hip fracture pain management.

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Systematic review and meta-analysis of single injection fascia iliaca blocks in the peri-operative management of patients with hip fractures

Cited by 7 publications

References 34 publications

Pain management after hip fracture repair surgery: a systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations

Pain management after hip fracture repair surgery: a systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations

Analgesic effect of pericapsular nerve group block on elderly patients undergoing hip replacement

Peripheral Nerve Blocks for Hip Fractures in Emergency Medicine

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