Fascia Iliaca Block versus Femoral Nerve Block as Post Operative Analgesia in Total Hip Arthroplasty

Abstract Background Total hip arthroplasty (THA) are common surgical procedures for treatment of the degenerative disorders and traumatic diseases. However, a majority of patients often experience moderate to severe postoperative pain after THA. Postoperative pain control has a significant impact on earlier ambulation, initiation of physiotherapy, and better functional recovery. In addition, effective pain control would lower the length of hospital stay and the risk of thrombotic events which improves patients’ satisfaction. Objective To assess the efficacy and safety of FICB compared with FNB. Patients and Methods After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients were included in the study, and were divided into two groups (n = 20; each); group FICB and FNB group. Group FICB: Patients (n = 20) of this group received ultrasound guided Fascia iliaca compartment block (FICB) before spinal anesthesia using 20-40 ml of 0.25% bupivacaine. Group FNB: Patients (n = 20) of this group received ultrasound guided femoral nerve block (FNB) before spinal anesthesia using 20-40 ml of 0.25% bupivacaine. Results The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first call for rescue analgesia. Demographic data, post-operative hemodynamics, and sedation score were also assessed. Conclusion Fascia iliaca compartment block is effective for pain relief during the early post- operative period after total hip arthroplasty. Meanwhile, it can reduce the cumulative meperidine consumption and the risk of opioid-related adverse effects.