Comparison of the Effectiveness of Suprainguinal Fascia Iliaca Compartment Block and Patient-Controlled Analgesia for Major Hip Surgeries in Elderly Patients.

Abstract

ObjectiveFascia iliaca compartment block is an alternative analgesic technique for hip surgeries. In the new suprainguinal technique, the ‘bowtie’ sign is detected with an ultrasound probe, and local anaesthetic is injected into the fascial plane with in-plane approach. In this retrospective study, we compared the postoperative analgesic efficacy of suprainguinal fascia iliaca compartment block (S-FICB) and patient-controlled analgesia (PCA) after major hip surgery in elderly patients.MethodsWe retrospectively recorded visual analogue scale (VAS) scores, morphine consumptions and opioid side effects who underwent either a S-FICB (n=67) or PCA (n=61). In the S-FICB group, 25–40 mL of 0.25% bupivacaine was administered with a single-shot S-FICB technique after induction of anaesthesia. VAS scores during resting (VAS-S) and movement (VAS-D); morphine consumption at 0, 6, 12, 24 and 48 hours; total morphine consumption; and opioid-related complications were recorded.ResultsMorphine consumptions in each measurement period and in total were significantly lower in the S-FICB group (694.03±2,007.47 μg vs. 13,368.85±4,834.68 μg; p<0.05). The total number of opioid-related complications were also significantly lower in the S-FICB group (17/67 vs. 48/62; p<0.05). More than half of the patients (38/67, 56%) did not need morphine administration in the S-FICB group. VAS-S during the first 6 hours and VAS-D up to 24 hours postoperatively were significantly lower in the S-FICB group (p<0.05).ConclusionIn our study, S-FICB provided better analgesia than the PCA technique after hip surgery in elderly patients. Moreover, S-FICB reduced opioid consumption and opioid-related complications in the first 24 hours postoperatively.