Fascia lliaca block for analgesia after hip arthroplasty: a randomized double-blind, placebo-controlled trial.

Published

Journal Article

BACKGROUND AND OBJECTIVES: Fascia iliaca block (FIB) is often used to treat pain after total hip arthroplasty (THA), despite a lack of randomized trials to evaluate its efficacy for this indication. The objective of this study was to assess the analgesic benefit of FIB after THA. Our primary hypothesis was administration of FIB decreases the intensity of postoperative pain (numeric rating scale [NRS-11] score) compared with sham block (SB) in patients after THA. METHODS: After institutional review board approval and informed consent, 32 eligible patients having THA were recruited. In the postoperative care unit, although all patients received intravenous morphine sulfate patient-controlled analgesia, patients reporting pain of 3 or greater on the NRS-11 scale were randomized to receive ultrasound-guided fascia iliaca (30 mL 0.5% ropivacaine) or SB (30 mL 0.9% NaCl) using identical technique, below fascia iliaca. The primary outcome was pain intensity (NRS-11) after FIB. RESULTS: Thirty-two patients (16 in each group) completed the study; all patients received an FIB. There was no difference in pain intensity (NRS-11 = 5.0 ± 0.6 vs 4.7 ± 0.6, respectively) after FIB versus SB or in opioid consumption (8.97 ± 1.6 vs 5.7 ± 1.6 mg morphine, respectively) between the groups at 1 hour. The morphine consumption after 24 hours was similar in both groups (49.0 ± 29.9 vs 50.4 ± 34.5 mg, P = 0.88, respectively). CONCLUSIONS: The evidence in these data suggests that the difference in average pain intensity after FIB versus SB was not significant (95% confidence interval, -2.2-1.4 NRS units).

Full Text

Duke Authors

Cited Authors

  • Shariat, AN; Hadzic, A; Xu, D; Shastri, U; Kwofie, K; Gandhi, K; McCally, CM; Gratenstein, K; Vandepitte, C; Gadsden, J; Unis, D

Published Date

  • May 2013

Published In

Volume / Issue

  • 38 / 3

Start / End Page

  • 201 - 205

PubMed ID

  • 23558369

Pubmed Central ID

  • 23558369

Electronic International Standard Serial Number (EISSN)

  • 1532-8651

Digital Object Identifier (DOI)

  • 10.1097/AAP.0b013e31828a3c7c

Language

  • eng

Conference Location

  • England