Is Femoral Nerve Block Superior to Fascia Iliac Block in Hip Surgery? Meta-Analysis of Randomized Controlled Trials

Abstract

Background. Femoral nerve block (FNB) and fascia iliac compartment block (FICB) are alternative methods of pain relief during hip surgery. Nevertheless, the effectiveness and safety of FNB compared with FICB are yet to be fully determined. Methods. Electronic databases were systematically searched. Only randomized controlled trials (RCTs) on hip surgery were included. Postoperatively, the pain scores at different time points, narcotic requirements in 24 h, mean arterial pressure, spinal anesthesia (SA) time, patient satisfaction, and adverse effect rates between the two groups were extracted throughout the study. Results. Fourteen RCTs including 1179 patients were included. Compared to the FICB, FNB decreased the VAS scores postoperatively at 24 h at rest ( P < 0.05 ) and the incidence rate of some side effects (nausea, vomiting, and sedation) ( P < 0.05 ). However, compared to the FICB, no significant difference was found in the FNB regarding the VAS scores postoperatively at any of the other time points (2 min, 20 min, 2 h, 24 h at movement, 48 h at rest, and 48 h at movement). Patients in both groups had similar narcotic needs after 24 h, mean arterial pressure, SA time, and patient satisfaction ( P > 0.05 ). Conclusions. FNB has more advantages in reducing VAS scores postoperatively at 24 h at rest and the odds of some adverse effects. A better quality RCT is needed to properly compare FNB with FICB.

Comparison between Ultrasound‐Guided Pericapsular Nerve Group Block and Local Infiltration Analgesia for Postoperative Analgesia after Total Hip Arthroplasty: A Prospective Randomized Controlled Trial

“…Peripheral nerve blocks are commonly used on the femoral nerve, fascia iliac, lumbar plexus, obturator nerve, and quadratus lumborum for postoperative analgesia in THA 13,14 . However, these procedures often reduce quadriceps muscle strength and can lead to falls 15–17 .…”

“…Peripheral nerve blocks are commonly used on the femoral nerve, fascia iliac, lumbar plexus, obturator nerve, and quadratus lumborum for postoperative analgesia in THA. 13 , 14 However, these procedures often reduce quadriceps muscle strength and can lead to falls. 15 , 16 , 17 Recently, the use of the ultrasound‐guided pericapsular nerve block in hip fractures has been described in the literature, which provides analgesia by blocking the obturator nerve (ON), accessory obturator nerve (AON), and femoral nerve in the anterior hip capsule without affecting quadriceps strength.…”

Ultrasound-guided pericapsular nerve group block versus fascia iliac compartment block for pain control in lower limb orthopedic surgery: A meta-analysis from randomized controlled trials

“…Published by Francis Academic Press, UK -15-such as respiratory depression, nausea, vomiting and dizziness after analgesia is relatively high, so the application of this method has certain limitations [3]. In recent years, with the mature application of ultrasound technology, FICB has been promoted as a valuable technique for regional anesthesia and analgesia in lower limb orthopedic surgery [4]. However, FICB was found to decrease quadriceps muscle strength, and the duration of postoperative analgesia was shorter [5][6].…”