Background and Aims Suprainguinal fascia iliaca compartment block (FICB) and anterior quadratus lumborum block (QLB) have been shown to provide analgesia after hip surgery. We tested whether suprainguinal FICB would result in less postoperative analgesic requirements than QLB in patients undergoing total hip replacement arthroplasty (THRA) under spinal anesthesia.
Methods Patients were randomly assigned to the FICB or QLB group. After the surgery, the FICB group received ultrasound-guided suprainguinal FICB using 30ml of 0.375% ropivacaine with 75µg of epinephrine added, and the QLB group received ultrasound-guided anterior QLB using the same mixture. A standardized multimodal analgesic regimen was used for postoperative pain control. The primary outcome was the total amount of opioids administered for 24 hours after surgery. Secondary outcomes were pain scores at rest and during movement for 24 hours, time to the first analgesic request, incidence of side effects, patient satisfaction, quality of recovery 24 hours after surgery, and time to discharge readiness.
Results Out of 80 patients, there was no significant difference in 24-hour opioid consumption in morphine milligram equivalents between the two groups (92.9 [60.3–122.9] mg vs. 86.2 [42.0–139.4] mg; P=0.725). The time to first analgesic request was longer in the FICB group (768 [385–970] min) than in the QLB group (448 [355–565] min; P=0.028). However, no difference was found in other parameters.
Conclusions Although total opioid consumption during the postoperative 24 hours did not differ, the time to first analgesic request was longer in the FICB group. Therefore, FICB may have a potential advantage in controlling breakthrough pain after spinal anesthesia.
IRB Decision Notification Document (2112-062-1282)