Comparison of Postoperative Analgesia between a Femoral Nerve Block with Local Infiltration Analgesia and a Suprainguinal Fascia Iliaca Compartment Block with Local Infiltration Analgesia for Total Hip Arthroplasty: A Prospective, Randomized, Open Label Trial

Shigehiko Urabe

Department of Anesthesia, Nagasaki Rosai Hospital 2-12-5 Setogoe, Sasebo 857-0134, Japan.

Yoshiaki Terao *

Department of Anesthesia, Nagasaki Rosai Hospital 2-12-5 Setogoe, Sasebo 857-0134, Japan.

Yuki Soejima

Department of Anesthesia, Nagasaki Rosai Hospital 2-12-5 Setogoe, Sasebo 857-0134, Japan.

Hiroki Iwanaga

Department of Anesthesia, Nagasaki Rosai Hospital 2-12-5 Setogoe, Sasebo 857-0134, Japan.

Natsuko Oji

Department of Anesthesia, Nagasaki Rosai Hospital 2-12-5 Setogoe, Sasebo 857-0134, Japan.

Makito Oji

Department of Anesthesia, Nagasaki Rosai Hospital 2-12-5 Setogoe, Sasebo 857-0134, Japan.

Tetsuya Hara

Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.

*Author to whom correspondence should be addressed.


Abstract

Aims: This study aimed to compare the analgesic efficacy between a suprainguinal fascia iliaca compartment (SFIC) block with local infiltration analgesia (LIA) and a femoral nerve (FN) block with LIA in patients who underwent total hip arthroplasty (THA).

Study Design: Prospective, randomized, open-label trial.

Place and Duration of Study: Department of Anesthesia, Nagasaki Rosai Hospital, Sasebo, Japan between May 2023 and March 2024.

Methodology: A total of 50 patients who underwent THA under total intravenous anesthesia using propofol were included in this study. The patients were randomly divided into two groups: Group F (n=25), which received an ultrasound-guided FN block with 30 mL of 0.25% levobupivacaine and Group S (n= 25), which received an ultrasound-guided SFIC block with 30 mL of 0.25% levobupivacaine. After fascial closure, both groups were administered 20 mL of 0.25% levobupivacaine on the incision line. All patients received 1000 mg intravenous acetaminophen prior to the end of the operation and at 6, 12, 18, and 24 h after the operation, and in those who needed it, diclofenac sodium 50 mg was used as a rescue analgesic. The nursing staff evaluated the postoperative pain using a numerical rating scale (NRS) at rest at 0, 1, 3, 6, 12, 18, and 24 h postoperatively and the number of analgesic requirements postoperatively.

Results: No significant differences were found between the two groups in terms of patient characteristics, except for the intraoperative fluid balance (1020 (783-1115) vs. 680 (570-980) ml,P = .01). Moreover, during the study period, no significant differences were observed between the two groups in the NRS scores (P = .25) and the number of rescue analgesic requirements (P =1.0).

Conclusion: Both the FN block with LIA and SFIC block with LIA would have an equivalent adjunctive analgesic effect after THA.

Keywords: Total hip arthroplasty, femoral nerve block, suprainguinal fascia iliaca compartment block, local infiltration analgesia, obturator nerve block, postoperative pain


How to Cite

Urabe, Shigehiko, Yoshiaki Terao, Yuki Soejima, Hiroki Iwanaga, Natsuko Oji, Makito Oji, and Tetsuya Hara. 2024. “Comparison of Postoperative Analgesia Between a Femoral Nerve Block With Local Infiltration Analgesia and a Suprainguinal Fascia Iliaca Compartment Block With Local Infiltration Analgesia for Total Hip Arthroplasty: A Prospective, Randomized, Open Label Trial”. Journal of Advances in Medicine and Medical Research 36 (8):100-107. https://doi.org/10.9734/jammr/2024/v36i85530.