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Letter
Assessing postoperative benefits of regional blocks: an issue that should be noticed
  1. Fu-Shan Xue,
  2. Nong He and
  3. Yi Cheng
  1. Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
  1. Correspondence to Dr Fu-Shan Xue, Department of Anesthesiology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing 100050, Beijing, China; Xuefushan{at}aliyun.com

https://doi.org/10.1136/rapm-2022-103959

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    To the editor

    In a single-blind randomized controlled trial including 86 patients who underwent posterolateral approach total hip arthroplasty, Carella et al 1 assessed the effects of suprainguinal fascia iliaca compartment block on postoperative opioid consumption and functional recovery and showed that the suprainguinal fascia iliaca compartment block provided opioid sparing, improved postoperative pain control and enhanced functional recovery. Other than the limitations described by authors in the discussion, however, this study used a single-mode postoperative analgesia strategy in the control patients, that is, patient-controlled analgesia with morphine. In fact, current enhanced recovery after surgery (ERAS) protocols of total hip arthroplasty recommend the multimodal strategies of postoperative analgesia, in which other than nerve or fascial plane blocks, a package of basic analgesics, such as paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs) or cyclooxygenase-2 specific inhibitors, and dexamethasone, is also included.2 3 Thus, we believe that different results about postoperative analgesic efficacy of the suprainguinal fascia iliaca compartment block would have been obtained, if a package of basic analgesics had been included in the postoperative analgesia strategy of control patients in this study.

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    References

    1. ↵
      2. Carella M ,
      3. Beck F ,
      4. Piette N , et al
      . Effect of suprainguinal fascia iliaca compartment block on postoperative opioid consumption and functional recovery in posterolateral-approached total hip arthroplasty: a single-blind randomized controlled trial. Reg Anesth Pain Med 2022;47:547–53.doi:10.1136/rapm-2021-103427 pmid:http://www.ncbi.nlm.nih.gov/pubmed/35705263
      OpenUrlAbstract/FREE Full Text
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      2. Oseka L ,
      3. Pecka S
      . Anesthetic management in early recovery after surgery protocols for total knee and total hip arthroplasty. Aana J 2018;86:32–9.pmid:http://www.ncbi.nlm.nih.gov/pubmed/31573492
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      2. Joshi GP ,
      3. Stewart J ,
      4. Kehlet H
      . Critical appraisal of randomised trials assessing regional analgesic interventions for knee arthroplasty: implications for postoperative pain guidelines development. Br J Anaesth 2022;129:142–4.doi:10.1016/j.bja.2022.04.019 pmid:http://www.ncbi.nlm.nih.gov/pubmed/35618537
      OpenUrlPubMed

    Footnotes

    • Contributors All authors had carefully read the manuscript of Carella et al, analyzed their methods and data. F-SX suggested comment points and drafted this manuscript and is the author responsible for this manuscript. NH and YC revised comment points and this manuscript. All authors had seen and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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