The effect of suprainguinal fascia iliaca block on the recovery of patients after arthroscopic hip surgery. Issue 8 (23rd June 2019)

• Record Type: Journal Article
• Authors: Alrayashi, Walid; Zurakowski, David; Sullivan, Cornelius Arthur; Berde, Charles B.; Askins, Nissa; Sinnott, Sean; Cravero, Joseph P.
• Editors: Kurth, Dean
• Is Part Of: Paediatric anaesthesia. Volume 29:Issue 8(2019:Aug.)
• Page Start: 829
• Page End: 834
• Publication Date: 2019-06-23
• Subjects: fascia iliaca -- hip arthroscopy -- nerve blocks -- regional anesthesia; Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.13663
• Languages: English
• ISSNs: 1155-5645

Abstract

Abstract: Background: Adolescent and young adult patients undergoing arthroscopic hip surgery experience significant pain in the immediate postoperative period. There is a small body of evidence that indicates suprainguinal fascia iliaca blocks can improve comfort during recovery from this intervention. Our hypothesis was that patients undergoing hip surgery would consume fewer opioids and have less pain in the perioperative time frame if they received the block as part of their analgesic regimen. Methods: In this study, we evaluated the outcomes of 716 patients, including 275 who received a suprainguinal fascia iliaca block, and 441 who did not have a block. Inclusion criteria included all age groups and American Society of Anesthesiologists, functional classes 1‐2. Patients who received other concurrent procedures or those with incomplete data sets were excluded. We utilized a regional anesthesia database that combined data from various repositories into one web‐based relational system. The primary outcomes were total opioid consumption and pain scores in the recovery room. Secondary outcomes included opioid side effects, block‐related complications, and total recovery room time. Multivariable logistic regression analysis was used to evaluate opioid consumption, side effects, and total recovery times. Pearson chi‐square was applied to assess the level of pain between the two groups. Results: Total opioid consumption was significantly less in the block group compared to those not receiving a block (0.28 mg/kg vs 0.35 mg/kg, P < 0.001, 95% CI of difference in medians 0.04‐0.10 mg/kg), but there was no statistical difference in pain scores. Patients with the regional block had a lower frequency of emesis in the PACU (0.7% vs 4.3%; P < 0.005, 95% CI of difference: 2‐25) and shorter PACU times (93 vs 108 minutes, P < 0.001, 95% CI of difference: 8‐23 minutes). Conclusion: Our study supports the clinical effectiveness of suprainguinal fascia iliaca blocks in young patients undergoing arthroscopic hip surgery.