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Abstract
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Background and Aims Regional anesthesia contributes to a multimodal analgesic approach. Suprainguinal Iliac fascia block is an alternative or complementary analgesic technique for knee, thigh and hip surgery.
Methods 80yo female, ASA II, with history of DM2 and hypertension proposed for total hip arthroplasty. To perform the block and catheter placement, a suprainguinal ecoguided approach was used. With the patient supine, a linear high frequency probe was placed in the sagittal plane to obtain an image of the ASIS. The probe was moved medially and the fascia iliaca identified. An in-plane approach and a StimuCath® Continuous Nerve Block Set with a 17G Tuohy needle and a 19G multi perforated catheter were used. 20mL 0,2% ropivacaine was given to open the fascial plane and the catheter introduced 3 cm in a cephalad direction. The surgery was realized under spinal anestesia. After the procedure a ionic contrast agent was infused through the catheter and X-ray images were obtained confirming the correct placement and spread. A bolus of 30ml ropivacaine 0.2% 6/6h through the catheter was prescribed and the analgesic regímen completed with NSAID and paracetamol. The catheter was removed 48h later.
Results The surgery lasted 70’ and there were no complications nor allergic reactions to the contrast. The patient remained confortable with no pain at rest and minimal pain at movement during the hospital stay and no rescue analgesia was necessary.
Contrast spread
Contrast spread
Contrast spread
Conclusions Continuous suprainguinal iliac fascia block may be another option in the pain management in non fast-track total hip arthroplasty