Comparison of Postoperative Analgesia between a Femoral Nerve Block with Local Infiltration Analgesia and a Suprainguinal Fascia Iliaca Compartment Block with Local Infiltration Analgesia for Total Hip Arthroplasty: A Prospective, Randomized, Open Label Trial

Aims: This study aimed to compare the analgesic efficacy between a suprainguinal fascia iliaca compartment (SFIC) block with local infiltration analgesia (LIA) and a femoral nerve (FN) block with LIA in patients who underwent total hip arthroplasty (THA).

Study Design: Prospective, randomized, open-label trial.

Place and Duration of Study: Department of Anesthesia, Nagasaki Rosai Hospital, Sasebo, Japan between May 2023 and March 2024.

Methodology: A total of 50 patients who underwent THA under total intravenous anesthesia using propofol were included in this study. The patients were randomly divided into two groups: Group F (n=25), which received an ultrasound-guided FN block with 30 mL of 0.25% levobupivacaine and Group S (n= 25), which received an ultrasound-guided SFIC block with 30 mL of 0.25% levobupivacaine. After fascial closure, both groups were administered 20 mL of 0.25% levobupivacaine on the incision line. All patients received 1000 mg intravenous acetaminophen prior to the end of the operation and at 6, 12, 18, and 24 h after the operation, and in those who needed it, diclofenac sodium 50 mg was used as a rescue analgesic. The nursing staff evaluated the postoperative pain using a numerical rating scale (NRS) at rest at 0, 1, 3, 6, 12, 18, and 24 h postoperatively and the number of analgesic requirements postoperatively.

Results: No significant differences were found between the two groups in terms of patient characteristics, except for the intraoperative fluid balance (1020 (783-1115) vs. 680 (570-980) ml,P = .01). Moreover, during the study period, no significant differences were observed between the two groups in the NRS scores (P = .25) and the number of rescue analgesic requirements (P =1.0).

Conclusion: Both the FN block with LIA and SFIC block with LIA would have an equivalent adjunctive analgesic effect after THA.