Key result
Preoperative suprainguinal fascia iliaca block significantly reduced the time to tracheal extubation (17.1 vs 28.0 minutes) and decreased postoperative pain compared to no block in elderly patients undergoing total hip arthroplasty.
Why the study?
Peripheral regional block combined with general anesthesia might be preferable for elderly patients receiving total hip arthroplasty, but whether suprainguinal fascia iliaca block accelerates general anesthesia recovery and relieves early postoperative pain was unclear.
Does preoperative suprainguinal fascia iliaca block accelerate recovery and relieve postoperative pain in elderly patients undergoing total hip arthroplasty under general anesthesia?
Cohort (n=31)
No
Does preoperative suprainguinal fascia iliaca block accelerate recovery and relieve postoperative pain in elderly patients undergoing total hip arthroplasty under general anesthesia?
Absolute Event Rate: 17.1% vs 28%
p-value: p=<0.01
Preoperative suprainguinal fascia iliaca block accelerates recovery from general anesthesia and reduces early postoperative pain and opioid consumption in elderly patients undergoing total hip arthroplasty.
May accelerate extubation and ease early pain after THA in elderly patients; leaves open efficacy and safety in randomized trials.
Background: Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients receiving total hip arthroplasty. To investigate whether suprainguinal fascia iliaca block accelerates recovery after general anesthesia and relieves early postoperative pain in elderly patients undergoing total hip arthroplasty. Methods: Patients who underwent total hip arthroplasty under general anesthesia in 2015 or 2019 at the Second Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The patients were grouped based on whether preoperative suprainguinal fascia iliaca block was performed. The time to tracheal extubation and spent in the post anesthesia care unit (PACU), intraoperative remifentanil dosage, fentanyl consumption in PACU, postoperative cumulative fentanyl consumption within 48 h after operation, visual analog scale (VAS) at rest and during movement on the first and second days after surgery, and adverse reactions were compared. Results: Thirty-one patients were included in the study (block group:16, no-block group: 15). The VAS at rest and during movement on the first and second days were significantly lower in the block group than in the no-block group (all P<0.05). The intraoperative remifentanil dosage, fentanyl consumption given in PACU, and postoperative cumulative fentanyl consumption in 48 h after operation were lower in the block group (all P<0.01). The time to tracheal extubation and the time spent in PACU in the block group were shorter (all P<0.01). Conclusion: Suprainguinal fascia iliaca block led to faster recovery after general anesthesia and early postoperative pain relief in elderly patients undergoing total hip arthroplasty.
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Wang et al. (2020) conducted a cohort in Hip fracture requiring total hip arthroplasty (n=31). Suprainguinal fascia iliaca block vs. No block (general anesthesia alone) was evaluated on Time to tracheal extubation (p=<0.01). Preoperative suprainguinal fascia iliaca block significantly reduced the time to tracheal extubation (17.1 vs 28.0 minutes) and decreased postoperative pain compared to no block in elderly patients undergoing total hip arthroplasty.
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