Effects of liposomal bupivacaine versus ropivacaine for fascia iliaca compartment block on postoperative pain and delirium in elderly patients undergoing hip arthroplasty.

OBJECTIVE

To compare the effects of fascia iliaca compartment block (FICB) with liposomal bupivacaine versus ropivacaine on postoperative pain and delirium in elderly patients undergoing total hip arthroplasty (THA).

METHODS

Eighty-six elderly patients who underwent THA were retrospectively enrolled. They were divided into a liposomal bupivacaine group (LB group, n=43) and a ropivacaine group (R group, n=43) based on the medication administered. Perioperative hemodynamic parameters, inflammatory markers, postoperative pain intensity, incidence of delirium, analgesic use, postoperative recovery outcomes, and complication rates were compared between the groups.

RESULTS

The LB group had significantly lower Numerical Rating Scale scores than the R group both at rest and on movement at 12, 24, 48, and 72 hours postoperatively (P<0.05). The LB group had significantly lower inflammatory marker levels than the R group at 24 and 48 hours postoperatively. The LB group had a significantly lower incidence of postoperative delirium (POD) than the R group (4.65% vs. 18.60%, P<0.05). The LB group had fewer patient-controlled intravenous analgesia (PCIA) attempts, longer time to first PCIA, and lower sufentanil consumption postoperatively (P<0.05). The LB group had significantly shorter time to first ambulation and length of hospital stay compared with the LB group (P<0.05).

CONCLUSION

FICB with liposomal bupivacaine may be associated with prolonged analgesia, a lower incidence of POD, faster recovery, and fewer complications in elderly patients undergoing THA.