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July 27, 2026JCA advances.Open Access

Fascia iliaca block versus lumbar erector spinae plane block for analgesia in elderly patients with hip fractures: A prospective exploratory observational study

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Key result

Lumbar erector spinae plane block provided similar postoperative pain control compared to fascia iliaca block in elderly patients with hip fractures (median NRS at rest at 12 h 0 vs 1, p=0.331).

Why the study?

To compare the analgesic efficacy of lumbar erector spinae plane block and fascia iliaca block in elderly patients undergoing surgery for hip fractures.

Does lumbar erector spinae plane block improve postoperative pain intensity compared to fascia iliaca block in elderly patients undergoing hip fracture surgery?

Population

Fifty patients aged ≥65 years scheduled for hip fracture surgery

Comparison

Ultrasound-guided FIB vs lumbar ESPB

Design

Prospective, exploratory, observational study

Follow-up

48 h

Authors

LBLaura BaianoVDValerio DonatielloACAntonio Coviello

Discussion

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Overview

Both blocks offered comparable analgesia and safety in elderly hip fracture patients; leaves open superiority in randomized trials.

Key Points

  • To compare the analgesic efficacy of ultrasound-guided lumbar erector spinae plane block versus fascia iliaca block in older adults undergoing hip fracture surgery.
  • Prospective, exploratory, observational study conducted at a major hospital in Naples, Italy.
  • Included 50 patients aged ≥65 years undergoing hip fracture surgery, receiving either preoperative fascia iliaca block (n=31) or lumbar erector spinae plane block (n=19) with 30 mL of 0.25% ropivacaine, followed by standardized spinal anesthesia.
  • Assessed pain via the Numeric Rating Scale (NRS) at 12, 24, and 48 hours, along with rescue analgesia timing, mobilization, bowel function, and adverse events.
  • Postoperative NRS pain scores showed no statistically significant differences at 12 hours at rest (median 1 for FIB vs. 0 for ESPB; p = 0.331) or during mobilization (median 4 for FIB vs. 2 for ESPB; p = 0.236), with no significant differences at 24 or 48 hours.
  • Timing of first rescue analgesia differed significantly (p = 0.001), occurring earlier in the FIB group (48% within 12 hours) compared to the ESPB group (37% between 12 and 24 hours).
  • All patients achieved mobilization within 48 hours, and adverse events were infrequent and comparable between groups.

Study Design

Type

Observational (n=50)

Multicenter

No

Structured PICO

Does lumbar erector spinae plane block improve postoperative pain intensity compared to fascia iliaca block in elderly patients undergoing hip fracture surgery?

P
Population
50 patients aged ≥65 years undergoing surgery for hip fractures, followed for 48 hours.
E
Exposure
Preoperative ultrasound-guided lumbar erector spinae plane block (ESPB) with 30 mL of 0.25% ropivacaine, followed by standardized spinal anesthesia with 10 mg of 0.5% ropivacaine
C
Comparator
Preoperative ultrasound-guided fascia iliaca block (FIB) with 30 mL of 0.25% ropivacaine, followed by standardized spinal anesthesia with 10 mg of 0.5% ropivacaine
O
Outcome
Postoperative pain intensity assessed using the Numeric Rating Scale (NRS) at 12, 24, and 48 hpatient reported

Main Result

Absolute Event Rate: 0% vs 1%

p-value: p=0.331

FIB and lumbar ESPB provide similar overall postoperative pain control and safety in elderly patients undergoing hip fracture surgery, though ESPB may offer a more gradual analgesic profile.

Cite This Study

Baiano et al. (2026) conducted an observational in hip fractures (n=50). Lumbar erector spinae plane block (ESPB) vs. Fascia iliaca block (FIB) was evaluated on postoperative pain intensity assessed using the Numeric Rating Scale (NRS) at 12, 24, and 48 h (p=0.331). Lumbar erector spinae plane block provided similar postoperative pain control compared to fascia iliaca block in elderly patients with hip fractures (median NRS at rest at 12 h 0 vs 1, p=0.331).

synapsesocial.com/papers/6a75ee93756843cacbb23a52https://doi.org/10.1016/j.jcadva.2026.100263
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative study between ultrasound-guided lumbar erector spinae plane block and fascia iliaca compartment block for postoperative analgesia after total hip arthroplasty2024 · 2 citations
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  3. 3Erector spinae plane block versus fascia iliaca block for hip arthroplasty: a systematic review and meta-analysis2026
  4. 4A comparative study between postoperative analgesia of suprainguinal fascia iliaca compartment block (SIFI) and lumbar erector spinae plane block (ESPB) in hip arthroplasty2024 · 7 citations
  5. 5Ultrasound-guided suprainguinal fascia iliaca block versus lumbar erector spinae block for oncologic thigh surgery.2025