Fascia iliaca compartment block for postoperative pain after total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials

Fascia iliaca compartment block for postoperative pain after total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials

Fascia iliaca compartment block (FICB) is one of the regional nerve blocks used to reduce pain after total hip arthroplasty (THA). We aim to assess the efficacy of FICB in reducing post-operative pain and opioid consumption. We searched PubMed, Web of Science, Cochrane Library, Embase, and Scopus on...

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Published in:BMC anesthesiology Vol. 24; no. 1; pp. 95 - 11
Main Authors: Eshag, Mona Muhe Eldeen, Hasan, Lina Omar Mahmoud, Elshenawy, Salem, Ahmed, Mennatallah Samir, Emad Mostafa, Abd El-Moneam, Abdelghafar, Yomna Ali, Althawadi, Yusuf Jasim, Ibraheem, Najwa Medhat, Badr, Helmy, AbdelQadir, Yossef Hassan
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 09-03-2024
BioMed Central
BMC
Subjects:
Analgesics
Analysis
Arthritis
Bupivacaine
Care and treatment
Clinical trials
Dexmedetomidine
Fascia
Fascia iliaca compartment block
Femur
FICB
Handbooks
Hip
Joint replacement surgery
Meta-analysis
Narcotics
Nausea
Osteoarthritis
Pain
Pain, Postoperative
Placebo
Postoperative pain
Quadriceps muscle
Rehabilitation
Software
Systematic review
Total hip arthroplasty
Total hip replacement
Vomiting
FICB
Postoperative pain
Fascia iliaca compartment block
Placebo
Opioid
Total hip replacement
Total hip arthroplasty
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Summary:Fascia iliaca compartment block (FICB) is one of the regional nerve blocks used to reduce pain after total hip arthroplasty (THA). We aim to assess the efficacy of FICB in reducing post-operative pain and opioid consumption. We searched PubMed, Web of Science, Cochrane Library, Embase, and Scopus on February 19, 2023, and we updated our search in august 2023 using relevant search strategy. Studies were extensively screened for eligibility by title and abstract screening, followed by full-text screening. We extracted the data from the included studies, and then pooled the data as mean difference (MD) or odds ratio (OR) with a 95% confidence interval (CI), using Review Manager Software (ver. 3.5). FIBC significantly reduced analgesic consumption at 24 h (MD = -8.75, 95% CI [-9.62, -7.88] P < 0.00001), and at 48 h post-operatively. (MD = -15.51, 95% CI [-26.45, -4.57], P = 0.005), with a significant sensory block of the femoral nerve (P = 0.0004), obturator nerve (P = 0.0009), and lateral femoral cutaneous nerve (P = 0.002). However, FICB was not associated with a significant pain relief at 6, 24, and 48 h postoperatively, except at 12 h where it significantly reduced pain intensity (MD = -0.49, 95% CI [-0.85, -0.12], P = 0.008). FICB was also not effective in reducing post-operative nausea and vomiting (MD = 0.55, 95% CI [0.21, 1.45], P = 0.23), and was associated with high rates of quadriceps muscle weakness (OR = 9.09, % CI [3.70, 22.30], P = < 0.00001). FICB significantly reduces the total analgesic consumption up to 48 h; however, it is not effective in reducing post-operative pain, nausea and vomiting and it induced postoperative muscle weakness.
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ISSN:1471-2253
1471-2253
DOI:10.1186/s12871-024-02476-y