Impact of continuous nerve block at different iliac fascia compartment regions on postoperative analgesia following total hip arthroplasty: A randomized controlled trial.

BACKGROUND

This study evaluates the analgesic efficacy of nerve block catheter placement in various regions of the iliac fascia compartment following total hip arthroplasty (THA).

METHODS

A total of 90 patients scheduled for unilateral THA were enrolled, comprising 46 males and 44 females, aged 55 to 75 years, with a body mass index of 18.0 to 30.0 kg/m2 and American Society of Anesthesiologists classification I or II. Patients were randomized into 3 groups of 30. All groups received general anesthesia in combination with nerve block anesthesia. The nerve block catheter was positioned in distinct regions of the iliac fascia compartment under bedside ultrasound and anteroposterior hip X-ray guidance. Based on anteroposterior hip X-rays, the ilium was divided into 3 regions - medial, middle, and lateral. Catheters were placed in the medial region in group I, the middle region in group II, and the lateral region in group III. The catheter depth within each region was recorded. Postoperative analgesia was managed using nerve block analgesia. The Numerical Rating Scale for pain, muscle strength, sensory level, effective analgesic pump compression counts, and adverse reactions during activity were assessed at 6, 12, 24, 36, and 48 hours postsurgery.

RESULTS

Numerical Rating Scale scores during activity at 12 to 48 hours postoperatively were significantly lower in groups I and II compared with group III (P < 0.05). In addition, the effective compression counts of the analgesic pump were significantly reduced in groups I and II compared with group III (P < .05).

CONCLUSION

Continuous fascia iliaca compartment block provides effective analgesia after THA, with catheter placement in the medial and middle regions offering superior analgesic outcomes compared with the lateral region.