Impact of femoral nerve block versus fascia iliaca block on postoperative pain control after hip arthroscopy: a prospective randomized trial

Abstract

Background & Objectives: Hip arthroscopy is a minimally invasive technique that has been widely used to treat a variety of hip joint diseases. However, severe postoperative pain usually follows these surgeries, necessitating the use of multimodal pain control strategies. Regional blocks like femoral nerve block (FNB) and fascia iliaca compartment block (FICB) allow for better postoperative analgesia while using less parenteral opioids. The purpose of this study was to evaluate and compare the efficacy of ultrasound guided FNB versus ultrasound guided FICB for postoperative analgesia.   Methodology: A total of 60 patients, planned for hip arthroscopy, aged 21−65 y, of either sex and ASA I−II were randomly divided into two groups: Group FICB (n= 30), in which FICB with 40 mL levobupivacaine 0.25% was done after induction of general anesthesia (GA) and Group FNB (n = 30) in which FNB with 20 mL levobupivacaine 0.25% was done after induction of GA. Time to the first analgesic use was the primary outcome, whereas total pethidine consumption as rescue analgesic in the first 24 h postoperatively, VAS scores, and the assessment of postoperative early ambulation were the secondary outcomes. Results: Patients in the Group FICB experienced a significantly shorter time to ambulation compared to Group FNB; 17.2 ± 2.1 vs. 19.8 ± 2.1 h respectively (P < 0.001). There were no significant differences between the two groups regarding time to first analgesic requirement (pethidine), total pethidine consumption, and the VAS scores. No cases of drug allergy were reported in both groups. Conclusion: Both fascia iliaca compartment block and femoral nerve block were effective in reducing postoperative pain; however, fascia iliaca compartment block was superior regarding early ambulation. Abbreviations: FNB: Femoral Nerve Block; FICB: Fascia Iliaca Compartment Block; GA: General Anesthesia; US: Ultrasound; VAS: Visual Analog Scale Key words: Hip arthroscopy; Fascia iliaca compartment block; Femoral Nerve Block; Pain; Pain Management; Postoperative pain Citation: Alasnsary AM, Elgouhary MO, Rashed MM, Ali MM. Impact of femoral nerve block versus fascia iliaca block on postoperative pain control after hip arthroscopy: a prospective randomized trial. Anaesth. pain intensive care 2022;27(1):23−30; DOI: 10.35975/apic.v27i1.2120 Received: September 10, 2022; Reviewed: November 05, 2022; Accepted: November 16, 2022