Key result
Ultrasound-guided fascia iliaca block was significantly worse than spinal morphine for 24-hour postoperative analgesia, resulting in 25 mg more intravenous morphine use (95% CI 9.0-30.5 mg, p<0.001).
Why the study?
Does ultrasound-guided fascia iliaca block reduce 24-h postoperative morphine consumption compared to spinal morphine in patients undergoing primary total hip arthroplasty?
RCT (n=108)
Double blind
Randomly allocated
No
Does ultrasound-guided fascia iliaca block reduce 24-h postoperative morphine consumption compared to spinal morphine in patients undergoing primary total hip arthroplasty?
Mean Difference: 25 (95% CI 9–30.5)
p-value: p=< 0.001
Ultrasound-guided fascia iliaca block provides significantly worse analgesia than spinal morphine in the first 24 hours after total hip arthroplasty.
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Favors spinal morphine over fascia iliaca block for THA analgesia; challenges routine use of ultrasound-guided blocks in orthopedic RCTs.
Kearns et al. (2016) conducted an RCT in Primary total hip arthroplasty (n=108). Ultrasound-guided fascia iliaca block with levobupivacaine vs. Spinal morphine 100 μg plus a sham ultrasound-guided fascia iliaca block using saline was evaluated on 24-h postoperative morphine consumption (MD 25, 95% CI 9.0-30.5, p=< 0.001). Ultrasound-guided fascia iliaca block was significantly worse than spinal morphine for 24-hour postoperative analgesia, resulting in 25 mg more intravenous morphine use (95% CI 9.0-30.5 mg, p<0.001).
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