Comparison of the Efficacy of Ultrasound-guided Supra-inguinal Fascia Iliaca and Lumbar Erector Spina Plan Block in Hip Fractures

Overview

The aim of our study was to evaluate the efficacy and patient satisfaction level of SI-FIB and lumbar ESPB for positioning and postoperative analgesia during spinal anesthesia in patients undergoing hip fracture surgery.

Hip fractures, which are one of the leading causes of mortality and morbidity with increasing age, are common and usually require surgery and cause severe pain in the perioperative period, which may result in delirium, sleep disturbances and chronic pain. This pain can be managed using neuraxial and regional techniques, as well as pharmacologic agents such as nonsteroidal analgesics, opioids and gabapentinoids, and interventions such as periarticular injections and peripheral nerve blocks. Supra-inguinal fascia iliaca block (SI-FIB) is a technique that blocks all components of the lumbar plexus, including the femoral nerve, latero-femoral nerve and obturator nerve. It is thought to function in a similar way to the anterior lumbar plexus block. Studies have successfully demonstrated the effectiveness of SIFIB in reducing postoperative pain after hip surgery. The lumbar erector spina plan block (ESPB) has been described for use in hip and femur surgery and radiologic evaluation and clinical results have shown that it provides similar analgesia to the lumbar plexus block at high volumes. It is accepted that multimodal analgesia is the best option for pain control and peripheral nerve blocks are effectively applied for this purpose. In this way, opioid use and related side effects such as nausea, vomiting, pruritus and sedation are reduced, and early mobilization, reduced hospital stay and prevention of postoperative complications are also contributed.

Conditions