Ultrasound-Guided Suprainguinal Fascia Iliaca Compartment Block in Combination with Sciatic Nerve Block for Pain Reduction in Total Hip Arthroplasty: A Prospective Randomized Controlled Study.

Abstract

Purpose: The aim of this study was to observe the intraoperative and postoperative analgesic effects of suprainguinal fascia iliaca compartment block (SFICB) combined with sciatic nerve block (SNB) in patients undergoing total hip arthroplasty (THA).

Patients and methods: Eighty-seven THA patients were randomly assigned to three groups: general anesthesia (Group C), general anesthesia with SFICB (Group F), and general anesthesia with SFICB and SNB (Group F+S). Numeric Rating Scale (NRS) scores were used to evaluate pain levels at rest and during activity at various postoperative time points. The secondary outcomes included heart rate (HR), mean arterial pressure (MAP), intraoperative sufentanil consumption, number of effective presses on the analgesic pump, rescue analgesic administration, postoperative nausea and vomiting, and serum levels of IL-1β and TNF-α.

Results: NRS scores were significantly lower in Groups F and F+S compared to Group C at different postoperative time points both at rest and during activity (P<0.05). Intraoperative sufentanil consumption, the number of effective presses on the analgesic pump, rescue analgesic administration, and postoperative nausea and vomiting were lower in Groups F and F+S compared to Group C (P<0.05). There were also significant differences in sufentanil consumption and the number of effective presses on the analgesic pump between groups F and F+S (P<0.05). The expression levels of IL-1β and TNF-α were lower in groups F and F+S compared to group C (P<0.05) at specific time points.

Conclusion: The application of ultrasound-guided SFICB combined with SNB for total hip arthroplasty can provide more comprehensive analgesia, reduce postoperative NRS scores, alleviate haemodynamic fluctuations, decrease opioid drug use, and reduce the serum levels of inflammatory factors, especially when combined with SNB.