Circum-Psoas Block Versus Supra-Inguinal Fascia Iliaca Block for Postoperative Analgesia in Patients Undergoing Total Hip Arthroplasty: A Randomized Clinical Trial

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2023 Nov 29

PMID 38026457

Authors

Junwei Zheng

Yan Mi

Jinghan Liang

Huili Li

Peiqi Shao

Hong Wen

Yun Wang

Affiliations

Soon will be listed here.

Abstract

Purpose: Total hip arthroplasty (THA) is often associated with moderate to severe pain. The present study compared the efficacy of circum-psoas block (CPB) with supra-inguinal fascia iliaca block (SIFIB) for postoperative analgesia in patients undergoing THA.

Patients And Methods: In this randomized trial, sixty-four patients undergoing THA were allocated randomly to the CPB group or SIFIB group with 40 mL of 0.3% ropivacaine. The primary outcome was dynamic pain score at 6 h postoperatively. Secondary outcomes included dynamic pain scores at 12, 24 and 48 h; static pain scores; sensory and motor block; opioid consumption; time to first opioid request; length of hospital stay; patient satisfaction; and adverse events.

Results: CPB patients showed significantly lower dynamic pain scores at 6 (3.11 ± 0.66 vs 4.47 ± 0.74, respectively; = 0.000), 12 (2.52 ± 0.73 vs 3.53 ± 0.85, respectively; = 0.000) and 24 h (2.30 ± 0.57 vs 2.87 ± 0.71, respectively; = 0.001) after surgery, as well as lower static pain scores at 6 and 12h ( = 0.001 and = 0.033 respectively) than SIFIB patients. Lower opioid consumption was observed in the CPB group at 24 and 48 h ( = 0.000, both) than in the SIFIB group. Patients in the CPB group reported improved quadriceps strength at 6 and 12 h ( = 0.000, both), as well as better muscle strength of hip flexion at 6, 12 and 24 h ( = 0.000, = 0.000 and = 0.025 respectively). Compared with SIFIB, CPB was associated with increased sensory block coverage at 6, 12 and 24 h ( = 0.000, = 0.000, and =0.022, respectively).

Conclusion: CPB has a greater potential to alleviate postoperative pain and improve recovery in THA patients than SIFIB.

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