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Open AccessArticle

Effectiveness of Fascia Iliaca Compartment Block after Elective Total Hip Replacement: A Prospective, Randomized, Controlled Study

1
Department of Anaesthesia and Intensive Care, Saint Lucas Hospital, Konskie 26-200, Poland
2
Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce 25-369, Poland
3
Intensive Care and Emergency Medicine, Department of Anaesthesiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice 40-055, Poland
4
Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesiain, Katowice 40-055, Poland
*
Authors to whom correspondence should be addressed.
Academic Editors:   Mirosław Czuczwar and Oliver Grundmann
Int. J. Environ. Res. Public Health 2021, 18(9), 4891; https://doi.org/10.3390/ijerph18094891
Received: 15 March 2021 / Revised: 28 April 2021 / Accepted: 29 April 2021 / Published: 4 May 2021
(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)
Objective: An assessment of the feasibility of fascia iliaca compartment block (FICB) combined with nonopioid analgesics and patient controlled analgesia (PCA), oxycodone, in the perioperative anaesthetic management for elective total hip replacement (THR). Design: A randomised, single-center, open-label study. Setting: A single hospital. The study was conducted from October 2018 to May 2019. Participants: In total, 109 patients were scheduled for elective total hip replacement. Interventions: Postoperative FICB with 0.375% ropivacaine in conjunction with nonopioid analgesics (paracetamol, metamizole, and pregabalin) and oxycodone as rescue analgesia. Measurements: Pain intensity was measured using the Numeric Pain Rating Scale (NRS) at rest and during rehabilitation, the total dose of postoperative oxycodone required, the occurrence of opioid-related adverse events, patient hospitalisation time, and level of satisfaction. Follow-up period: 48 h. Main Results: A total of 109 patients were randomised into two groups and, of these, 9 were subsequently excluded from the analysis (three conversions to general anaesthesia, two failures to perform FICB, four failures to use the PCA pump). Patients in the FICB group received standard intravenous analgesia with FICB, and those in the control group were managed with standard intravenous analgesia only. Pain level measured with NRS was significantly lower at rest and during rehabilitation in the FICB group. Oxycodone use in the first 48 h was significantly higher in the control group (p < 0.001); additionally, the time to the first dose of rescue analgesia was significantly shorter (p < 0.001). In the control group, there was a higher rate of side effects and a significantly longer hospitalisation time (p < 0.001). Similarly, higher satisfaction with the applied analgesic treatment was noted in the FICB group. Conclusions: FICB in elective THR treatments is an effective form of analgesia, which reduces the need for opioids, the number of complications, the length of hospitalisation, and which ensures a high level of patient satisfaction with the analgesic treatment used. Trial registration: ClinicalTrials.gov No. NCT04690647. View Full-Text
Keywords: regional anesthesia; multimodal analgesia; fascia iliaca compartment block; total hip replacement regional anesthesia; multimodal analgesia; fascia iliaca compartment block; total hip replacement
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MDPI and ACS Style

Gola, W.; Bialka, S.; Owczarek, A.J.; Misiolek, H. Effectiveness of Fascia Iliaca Compartment Block after Elective Total Hip Replacement: A Prospective, Randomized, Controlled Study. Int. J. Environ. Res. Public Health 2021, 18, 4891. https://doi.org/10.3390/ijerph18094891

AMA Style

Gola W, Bialka S, Owczarek AJ, Misiolek H. Effectiveness of Fascia Iliaca Compartment Block after Elective Total Hip Replacement: A Prospective, Randomized, Controlled Study. International Journal of Environmental Research and Public Health. 2021; 18(9):4891. https://doi.org/10.3390/ijerph18094891

Chicago/Turabian Style

Gola, Wojciech; Bialka, Szymon; Owczarek, Aleksander J.; Misiolek, Hanna. 2021. "Effectiveness of Fascia Iliaca Compartment Block after Elective Total Hip Replacement: A Prospective, Randomized, Controlled Study" Int. J. Environ. Res. Public Health 18, no. 9: 4891. https://doi.org/10.3390/ijerph18094891

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