Effectiveness of Fascia Iliaca Compartment Blocks for Pain Relief After Hip Arthroplasty Using Ropivacaine and Dexamethasone.

BACKGROUND

Fascia iliaca compartment block (FICB) is one of the regional blocks used to reduce postoperative pain after total hip arthroplasty (THA). Administration of dexamethasone in the loading dose might lengthen pain-free duration and reduce anesthetic consumption.

METHODS

Sixty patients undergoing THA with spinal anesthesia and patient-controlled FICB were randomly assigned to receive either 20 mL of 0.25% ropivacaine with 8 mg dexamethasone (Group D, n = 30) or 20 mL of 0.25% ropivacaine alone (Group C, n = 30). Postoperative pain scores, analgesic use, and side effects were assessed over 72 hours.

RESULTS

Postoperative visual analogue scale scores did not differ significantly between groups. The time to first bolus was longer in Group D than in Group C (407.10 ± 305.68 vs. 308.63 ± 212.99 minutes; P < 0.05). Total ropivacaine consumption over 72 hours was lower in Group D (210.33 ± 79.64 mg) compared to Group C (288.00 ± 91.32 mg), with a similar reduction in bolus frequency (14.53 ± 7.96 vs. 22.30 ± 9.13). The incidence of adverse events, including quadriceps weakness, local effects, and other side effects, was low and comparable between groups.

CONCLUSION

The addition of dexamethasone to ropivacaine for FICB after THA can significantly provide a longer duration of analgesia with a lower amount of anesthetic.