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OP043 An iliopsoas plane block reduces opioid consumption after hip arthroscopy by 56% without compromising ambulation. a double blind, randomized trial
  1. Christian Jessen1,2,
  2. Lone Dragnes Brix1,
  3. Thomas Dahl Nielsen3,
  4. Ulrick Skipper Espelund1,2,
  5. Bent Lund4,2 and
  6. Thomas Fichtner Bendtsen3,2
  1. 1Department of Anesthesiology and Intensive Care, Horsens Regional Hospital, Horsens, Denmark, Horsens, Denmark
  2. 2Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark, Aarhus, Denmark
  3. 3Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark, Aarhus, Denmark
  4. 4Department of Orthopedic Surgery, Horsens Regional Hospital, Horsens, Denmark, Horsens, Denmark


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Background and Aims Hip arthroscopy is associated with pain due to the intraoperative stretching of the hip capsule and the surgical intervention. Pain is predominantly generated by nociceptors in the anterior part of the hip joint capsule, which is innervated by the femoral nerve. Pain can be relieved by a femoral nerve block that impedes ambulation or opioids causing nausea and vomiting. An iliopsoas plane block (IPB) anesthetizes the hip joint capsule without compromising the ability to ambulate

Methods In a randomized double-blind trial approved by the Central Denmark Region Committee on Health Research Ethics 50 patients scheduled for hip arthroscopy in general anesthesia were randomized to active or placebo IPB (figure 1). The primary outcome was IV morphine equivalent consumption the first three postoperative hours in the post anesthesia care unit (PACU). Secondary outcomes were pain (NRS 0-10), nausea and ability to ambulate.

Abstract OP043 Figure 1

Consort diagram of patient flow in the study. Placebo (Blue); IPB, iliopsoas plane block (Red)

Abstract OP043 Figure 2

Scatter plot of the effect of the active iliopsoas plane block and placebo block on consumption of intravenous morphine equivalents during the first three postoperative hours. A random scatter of 0-4 mg was applied to separate data points graphically. IPB, Iliopsoas Plane Block; IV, Intravenous; mg, milligram; Magenta diamond, mean opioid consumption

Abstract OP043 Table 1

NRS values are reported as median [IQR] and quadriceps strength as mean (SD). Other values are count or mean (SD) as appropriate. IVeq., Intravenous equivalents; PACU, post-anesthesia care unit; NRS, numeric rating scale; N, Newton; Sec, seconds; mg, milligrams; min, minutes; µg, micrograms; no., numbers

Results The IV opioid consumption was reduced by 56% in the active IPB group versus the placebo IPB group, 10.4 mg (5.5) versus 23.8 mg (9.6) respectively (p<0.001) – see figure 2/table 1. No intergroup differences were observed regarding pain, nausea or ability to ambulate during the three-hour follow-up (table 1).

Conclusions An IPB reduced the postoperative opioid consumption by 56% after hip arthroscopy in this randomized double blind trial.

  • Less opioid after hip arthroscopy with iliopsoas plane block.

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