A Prospective Randomized Controlled Trial Comparing the Efficacy of Fascia Iliaca Compartment Block Versus Local Anesthetic Infiltration After Hip Arthroscopic Surgery

Abstract

To compare the efficacy of fascia iliaca compartment block (FICB) with local anesthetic infiltration (LAI) of the arthroscopy portals for pain control after hip arthroscopy. A prospective single-blinded randomized controlled trial that involved patients who underwent hip arthroscopy was performed. Participants were randomized to receiving either FICB or LAI of the portal tracts with local anesthetic. Supplemental analgesia was also used in both groups on an on-demand basis. The primary outcome measure was the postoperative level of pain as assessed by numeric pain score at 1, 3, 6, and 24hours after the procedure in both groups. Secondary outcome measures were the frequency and the dose of morphine and other medications consumed at 1 and 24hours after surgery as well as any other adverse events relating to pain or medications used for pain relief in both the groups. The study had to be terminated early because there was a significant statistical difference in the primary outcome measure after the recruitment of 46 patients: 20 in the LAI group and 26 in the FICB group. Severity of pain in the FICB group was higher especially during the first hour postoperatively (P= .02). This was associated with a higher consumption of opioids and other analgesics, which resulted in more side effects such as nausea and vomiting. LAI provided a better analgesia after arthroscopic surgery of the hip in comparison with FICB and was also associated with reduced consumption of opioids and a lower rate of side effects. Level I, single-blinded randomized controlled study.