Ultrasound-guided fascia iliaca compartment block for pain control in total hip arthroplasty: A systematic review and meta-analysis

Abstract

Background: Previous studies have investigated the effectiveness and safety of ultrasound-guided fascia iliaca compartment block (UGFICB) compared to quadratus lumborum block (QLB) for pain management in total hip arthroplasty (THA). However, there is currently a lack of a systematic review specifically addressing this issue. Therefore, the purpose of this study was to conduct a comprehensive analysis and comparison of the efficacy and safety of UGFICB versus QLB for pain management in THA. Methods: An extensive search was conducted in various electronic databases, including PUBMED, EMBASE, Cochrane Library, Web of Science, Scopus, China Biomedical Literature Service System, and China National Knowledge Infrastructure. This search encompassed all relevant studies published from the inception of these databases until June 30, 2023. The selected outcomes for analysis included moving and resting visual analogue scale (VAS) scores at 12 hours and 24 hours post-surgery, as well as opioids consumption at 24 hours post-surgery. The Cochrane risk-of-bias tool was utilized to assess the risk of bias in the trials included in the analysis. Statistical analysis was conducted using RevMan 5.4 software. Results: A total of 8 trials, involving 656 patients, were included in this study. The results of the meta-analysis showed no significant differences between the 2 modalities in terms of moving VAS scores (mean difference [MD] = 0.17, 95% confidence interval [CI] [−0.79, 1.14], P = .72) and resting VAS scores (MD = 0.04, 95% CI [−0.27, 0.36], P = .78) at 12 hours post-surgery, and moving VAS scores (MD = 0.27, 95% CI [−0.46, 1.01], P = .47) and resting VAS scores (MD = −0.05, 95% CI [−0.45, 0.35], P = .80) at 24 hours post-surgery. However, there was significant differences in opioids consumption at 24 hours post-surgery (MD = 8.98, 95% CI [2.04, 15.93], P = .01) between the 2 groups. Conclusion: Based on these findings, the study concludes that UGFICB may be more beneficial than QLB for pain management in THA. However, it is important to interpret these results with caution due to certain limitations.