Ignacio Badiola1, Jiabin Liu2, Stephanie Huang2, John D Kelly3, Nabil Elkassabany4. 1. Department of Anesthesiology and Critical Care, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States. Electronic address: Ignacio.badiola@uphs.upenn.edu. 2. Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, United States. 3. Department of Orthopaedics, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States. 4. Department of Anesthesiology and Critical Care, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States. Electronic address: Nabil.elkassabany@uphs.upenn.edu.
Abstract
STUDY OBJECTIVE: This randomized controlled single blinded clinical trial compared the fascia iliaca block (FIB) and the lumbar plexus block (LPB) in patients with moderate to severe pain following hip arthroscopic surgery. DESIGN: Single blinded randomized trial. SETTING: Postoperative recovery area, postoperative days 0 and 1. PATIENTS: Fifty patients undergoing hip arthroscopy were approached in the Post Anesthesia Care Unit (PACU) if they had moderate to severe pain (defined as > or equal 4/10 on the numeric rating scale). Twenty-five patients were allocated to the FIB and twenty-five patients to the LPB. INTERVENTIONS:Fascia iliaca block or lumbar plexus block. MEASUREMENTS: A blinded observer recorded pain scores just prior to the block, 15 min following the block (primary endpoint), and then every 15 min for 2 h (or until the patient was discharged). Total PACU time and opioid use were recorded. Pain scores and analgesic use on postoperative day (POD) 0, and POD 1 were recorded. At 24 h post block the Quality of Recovery 9 questionnaire was administered. RESULTS: The mean pre-block pain scores were comparable between the two groups (P = 0.689). There was no difference in mean post block pain scores between the two groups at 15 min (P = 0.054). In the PACU patients who underwent a LPB consumed less opioids compared to FIB patients (P = 0.02), however no differences were noted between the two groups in PACU length of stay, or POD 0 or 1 opioid use. CONCLUSION: A fascia iliaca block is not inferior to a lumbar plexus block in reducing PACU pain scores in patients with moderate to severe pain following hip arthroscopic surgery and is a viable option to help manage postoperative pain following hip arthroscopic surgery.
RCT Entities:
STUDY OBJECTIVE: This randomized controlled single blinded clinical trial compared the fascia iliaca block (FIB) and the lumbar plexus block (LPB) in patients with moderate to severe pain following hip arthroscopic surgery. DESIGN: Single blinded randomized trial. SETTING: Postoperative recovery area, postoperative days 0 and 1. PATIENTS: Fifty patients undergoing hip arthroscopy were approached in the Post Anesthesia Care Unit (PACU) if they had moderate to severe pain (defined as > or equal 4/10 on the numeric rating scale). Twenty-five patients were allocated to the FIB and twenty-five patients to the LPB. INTERVENTIONS:Fascia iliaca block or lumbar plexus block. MEASUREMENTS: A blinded observer recorded pain scores just prior to the block, 15 min following the block (primary endpoint), and then every 15 min for 2 h (or until the patient was discharged). Total PACU time and opioid use were recorded. Pain scores and analgesic use on postoperative day (POD) 0, and POD 1 were recorded. At 24 h post block the Quality of Recovery 9 questionnaire was administered. RESULTS: The mean pre-block pain scores were comparable between the two groups (P = 0.689). There was no difference in mean post block pain scores between the two groups at 15 min (P = 0.054). In the PACUpatients who underwent a LPB consumed less opioids compared to FIB patients (P = 0.02), however no differences were noted between the two groups in PACU length of stay, or POD 0 or 1 opioid use. CONCLUSION: A fascia iliaca block is not inferior to a lumbar plexus block in reducing PACUpain scores in patients with moderate to severe pain following hip arthroscopic surgery and is a viable option to help manage postoperative pain following hip arthroscopic surgery.
Authors: Maria A Munsch; Garrhett G Via; Austin J Roebke; Joshua S Everhart; John M Ryan; W Kelton Vasileff Journal: J Clin Orthop Trauma Date: 2022-03-25
Authors: Lauren DeLong; Senthil Krishna; Catherine Roth; Giorgio Veneziano; Mauricio Arce Villalobos; Kevin Klingele; Joseph D Tobias Journal: Local Reg Anesth Date: 2021-10-19