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Observational study reveals continuous infusion of levobupivacaine may reduce postoperative acute pain in total hip arthroplasty.
Purpose We conducted a retrospective observational study to assess if the combinational continuous suprainguinal fascia iliaca block and pericapsular nerve group block would be effective in inhibiting postoperative pain in patients undergoing total hip arthroplasty. Methods In 40 patients who underwent elective total hip arthroplasty via anterior approach (April, 2023–April, 2024), suprainguinal fascia iliaca block and PENG block were performed with 25 mL of 0.2% levobupivacaine before induction of general anesthesia. Postoperatively, 0.125% levobupivacaine was continuously infused (at 4 mL h −1 ) for suprainguinal fascia iliaca block. Postoperatively, the numerical rating scale (NRS) of pain at rest was recorded immediately after surgery and at 2, 6, 12, 24, and 48 h after surgery. Primary outcome measure was the incidence of rebound pain, and secondary outcome measure was the incidence of postoperative acute pain. Results Postoperative acute pain was observed in 22 of 39 patients (56% [95% confidence interval: 40%–72%]). In the remaining 17 patients, rebound pain was observed in 2 (12% [95% confidence interval: 0%–27%]). Conclusions We conclude that in the patients who underwent total hip arthroplasty via anterior approach, combinational use of continuous suprainguinal fascia iliaca block and PENG block may frequently be insufficient to prevent postoperative acute pain but may be effective in reducing the incidence of rebound pain.
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Doi et al. (2025) studied this question.
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