Effect Of Fascia Iliaca Compartment Block Research Articles

Randomized controlled trial on analgesic effect of pre-operative fascia iliaca compartment block in geriatric patients with hip fracture

Objective While most geriatric patients with hip fracture benefit from definitive operative treatment, pre-operative pain management is often overlooked. Conventional oral analgesics may provide suboptimal pain control, resulting in poor morbidity outcomes. Fascia iliaca compartment block (FICB) provides a more consistent analgesic effect. This study aims to provide high level local evidence on the effect of FICB in pre-operative pain control for these patients in Hong Kong. Materials and Methods This study was a double-blinded randomized controlled trial. Mentally competent geriatric patients with acute fracture hip, admitted to United Christian Hospital, were recruited to receive pre-operative FICB. The procedure was carried out by landmark approach with addition of ultrasonography-guidance. They were randomized into intervention group (receiving 0.25% levobupivacaine), and control group (receiving normal saline as placebo). Numeric Rating Scale of pain score (at rest, and on gentle movement) at different time intervals, timing of injection, systemic analgesic use, complications, and demographics were compared. Results Total 80 patients were recruited from July 2019 to September 2021 and randomized into intervention and control groups. Two patients in intervention group and 1 in control group were withdrawn due to development of delirium. Demographics of both groups were comparable. Pain score at rest was significantly lower at 12 h after injection in intervention group (41.4% reduction, p = 0.03). Pain score upon gentle movement was significantly lower in intervention group at 1 h (p = 0.01), 12 h (28.9% reduction, p = 0.003) and 24 h after injection (p = 0.01). There was no complication from the procedure documented. Total systemic analgesic use was similar in both groups. Conclusion FICB is an effective choice of pre-operative analgesia for geriatric hip fracture patients with good safety profile, especially in controlling pain induced by movement. It shall be considered as a routine practice for suitable patients.

Effects of fascia iliaca compartment block as an adjunctive management to parecoxib for pain control after total hip arthroplasty.

Background:This retrospective study investigated the effects of fascia iliaca compartment block (FICB) as an adjunctive management to parecoxib for pain control after total hip arthroplasty (THA).Methods:A total of 72 patient records of THA were included in this retrospective study. All patients received parecoxib and were allocated to either the treatment group (n = 36) or the control group (n = 36). In addition, patients in the treatment group underwent FICB. The primary outcome was pain intensity measured using a resting and moving visual analog scales (VASs). The secondary outcomes were inflammatory factors (interleukin 6 and C-reactive protein) and occurrence rate of adverse events.Results:Patients in the treatment group had better outcomes in the resting VAS (12 hours, P < .01; 24 hours, P < .01; 36 hours, P = .01; 72 hours, P = .03), moving VAS (12 hours, P < .01; 24 hours, P < .01; 36 hours, P = .02; 72 hours, P = .02), serum interleukin 6 (P < .01), and C-reactive protein (P < .01) than those in the control group at different time points. In addition, there were no significant differences in the occurrence rate of adverse events.Conclusion:The findings of this study demonstrated that the effects of FICB as an adjunctive management to parecoxib are superior to those of parecoxib alone for pain control after THA.