Suprainguinal Fascia Iliaca Block (SIFB) Vs Multimodal analgesia for pain control following hip hemiarthroplasty - Trial PACTR202305920421968

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Summary

Optimal perioperative pain management of hip surgery improves the long-term quality of life (Young et al.,2014).Nerve blocks are expected to be more effective for peri-operative pain management than other analgesic techniques (Guay et al.,2017).Although epidural anesthesia and lumbar plexus nerve block for hip surgery were effective analgesics in the perioperative period, performing these nerve blocks was associated with hypotension. Femoral neve block and local infiltration analgesia are not ideal because they don’t cover the full extent of analgesia required for hip surgery (Johnson et al.,2017) (Kuchálik et al.,2017). The fascia iliaca compartment block (FICB) was initially described by (Dalens et al.,1989) on children using a landmark technique. It is an easy to perform and a low-cost procedure which provides efficient perioperative analgesia for patients who suffer from hip or femur fractures. Increased success rates are due to the facilitation of the block via ultrasound which is easily accessible in many operation theaters (Onur et al., 2019).The ultrasound-guided suprainguinal fascia iliaca block, described by Hebbard in 2011, further built on earlier anatomic discoveries to more reliably anesthetize the 3 nerves originally targeted by Winnie: femoral, lateral femoral cutaneous, and obturator. (Hebbard et al., 2011) (Winnie et al., 1973)This relatively simple block has most notably been shown to provide opioid- sparing analgesia in the setting of hip surgery. (Desmet et al., 2017)Aim of this study is to analyze the effectiveness of ultrasound-guided supra inguinal fascia iliaca compartment block (SIFI) versus multimodal analgesia for postoperative pain relief in hip hemiarthroplaty. Main variables will be the total amount of opioid consumption by the patient, analgesic requirements and ambulation.

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