Assessing postoperative benefits of regional blocks: an issue that should be noticed

Abstract

To the editor In a singleblind randomized controlled trial including 86 patients who underwent posterolateral approach total hip arthroplasty, Carella et al assessed the effects of suprainguinal fascia iliaca compartment block on postoperative opioid consumption and functional recovery and showed that the suprainguinal fascia iliaca compartment block provided opioid sparing, improved postoperative pain control and enhanced functional recovery. Other than the limitations described by authors in the discussion, however, this study used a singlemode postoperative analgesia strategy in the control patients, that is, patientcontrolled analgesia with morphine. In fact, current enhanced recovery after surgery (ERAS) protocols of total hip arthroplasty recommend the multimodal strategies of postoperative analgesia, in which other than nerve or fascial plane blocks, a package of basic analgesics, such as paracetamol, nonsteroidal antiinflammatory drugs (NSAIDs) or cyclooxygenase2 specific inhibitors, and dexamethasone, is also included. 3 Thus, we believe that different results about postoperative analgesic efficacy of the suprainguinal fascia iliaca compartment block would have been obtained, if a package of basic analgesics had been included in the postoperative analgesia strategy of control patients in this study.