Does Adding Posterior Block to SFIB Increase the Quality of Analgesia in Hip Fractures?

Does the Addition of a Deep Posterior Gluteal Compartment Block to Suprainguinal Fascia Iliaca Block Improve Analgesia in Hip Fracture Surgery? A Randomized Controlled Trial

The researchers aimed to compare the effects of adding a Deep Posterior Gluteal Compartment Block to a Suprainguinal Fascia Iliaca Compartment Block (SFICB) versus SFICB alone on pain, analgesic consumption, and positioning pain for neuraxial anesthesia.

Study Overview

• Status: Completed
• Conditions: Hip Surgery; Acute Pain Management
• Intervention / Treatment: Other: Suprainguinal fascia iliaca compartment block; Other: Deep Posterior Gluteal Compartment Block

Detailed Description

Adding Deep Posterior Gluteal Compartment Block to Suprainguinal Fascia Iliaca Block applied before neuraxial anesthesia in hip fracture surgeries can reduce the pain sensation originating from the posterior region of the hip joint. Thus, participants can experience less pain in the perioperative period, consume less analgesics and reduce complications related to these in the postoperative period. In addition, possible complications can be prevented with early mobilization of the participants. It was aimed to compare the effects of adding Deep Posterior Gluteal Compartment Block to Suprainguinal Fascia Iliaca Block with only Suprainguinal Fascia Iliaca Block on these results.

• Study Type: Interventional
• Enrollment (Actual): 68
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ilkadım
    • Samsun, Ilkadım, Turkey (Türkiye)
      • Samsun University, Samsun Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Volunteering to participate in the study
• Patients between the ages of 18-90
• ASA I, II, III
• Patients whose surgery duration does not exceed 2 hours
• Patients who will undergo surgery under spinal anesthesia

Exclusion Criteria:

• Patients who do not want to participate in the study/do not give consent
• Patients with a condition that prevents regional anesthesia
• Patients with cognitive dysfunction who are unable to evaluate the NRS score and who cannot use PCA (Patient Controlled Analgesia Device)
• History of hypersensitivity or allergy to local anesthetics
• Patients with psychiatric disorders and those using psychiatric medications
• Presence of hematological disease
• Presence of oncological disease
• Patients with serious major organ failure
• Presence of multiple fractures
• Patients with alcohol or drug addiction
• Patients who have used analgesic drugs up to 12 hours before surgery
• ASA IV-V patients
• Morbidly obese patients

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group SFICB; Suprainguinal fascia iliaca plane block will be performed 30 minutes before hip surgery	Other: Suprainguinal fascia iliaca compartment block; Suprainguinal fascia iliaca compartment block will be performed under USG guidance before neuraxial anesthesia.
Active Comparator: Group Combined; Suprainguinal Fascia İliaca plane Block will be performed 30 minutes before hip surgery and Deep Posterior Gluteal Compartment Block will be performed 20 minutes before hip surgery	Other: Suprainguinal fascia iliaca compartment block; Suprainguinal fascia iliaca compartment block will be performed under USG guidance before neuraxial anesthesia.; Other: Deep Posterior Gluteal Compartment Block; Deep Posterior Gluteal Compartment Block will be performed under USG guidance before neuraxial anesthesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Opioid consumption	In the postoperative period, patients will be given opioids according to their pain density with a patient-controlled device, and the daily Morphine consumption in Patient Controlled Analgesia device will be collected and compared between groups.	24 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of recovery 15 scale	Postoperative Quality of Recovery 15 in Turkish scale	24 hours after surgery
Perioperative pain intensity	Changes in the Numerical Rating Scale (NRS) will be recorded at rest and during movement. The participant's baseline NRS will be recorded, followed by measurements before and after neuraxial positioning and up to 24 hours post-surgery. The NRS is a unidimensional measure of pain intensity in adults. It is a segmented numerical version of the Visual Analog Scale (VAS) where the participant selects a whole number (0-10) that best represents the intensity of their pain. The 11-point numerical scale ranges from '0' representing one end of the pain spectrum (e.g. 'no pain') to '10' representing the other end (e.g. 'worst imaginable pain').	24 hours
Quality of patient's position for neuraxial anesthesia	The position will be evaluated by anesthesiologist and characterized as "unsatisfactory", "satisfactory", "good" or "very good"	up to ten minutes
Quadriceps weakness	Quadriceps strength will be graded according to a 3-point scale: normal strength = 0 point (extension against resistance); paresis = 1 point (extension against gravity but not against resistance); and paralysis = 2 points (no extension).	24th hours

Collaborators and Investigators

• Sponsor: Samsun University
• Investigators: Study Director: Hatice Selcuk Kusderci, Samsun University

Publications and helpful links

General Publications

• Roche JJ, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005 Dec 10;331(7529):1374. doi: 10.1136/bmj.38643.663843.55. Epub 2005 Nov 18.
• Safa B, Trinh H, Lansdown A, McHardy PG, Gollish J, Kiss A, Kaustov L, Choi S. Ultrasound-guided suprainguinal fascia iliaca compartment block and early postoperative analgesia after total hip arthroplasty: a randomised controlled trial. Br J Anaesth. 2024 Jul;133(1):146-151. doi: 10.1016/j.bja.2024.04.019. Epub 2024 May 18.
• Vermeylen K, Van Aken D, Versyck B, Casaer S, Bleys R, Bracke P, Groen G. Deep posterior gluteal compartment block for regional anaesthesia of the posterior hip: a proof-of-concept pilot study. BJA Open. 2023 Feb 15;5:100127. doi: 10.1016/j.bjao.2023.100127. eCollection 2023 Mar.

Study record dates

Study Major Dates

• Study Start (Actual): February 24, 2025
• Primary Completion (Actual): December 15, 2025
• Study Completion (Actual): December 31, 2025

Study Registration Dates

• First Submitted: December 11, 2024
• First Submitted That Met QC Criteria: February 17, 2025
• First Posted (Actual): February 21, 2025

Study Record Updates

• Last Update Posted (Actual): January 6, 2026
• Last Update Submitted That Met QC Criteria: January 5, 2026
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: hip surgery; acute pain management; Deep posterior gluteal compartment block; Suprainguinal fascia iliaca plane block
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Wounds and Injuries; Leg Injuries; Fractures, Bone; Femoral Fractures; Hip Injuries; Acute Pain; Hip Fractures
• Other Study ID Numbers: OMUKAEAK 2024/276

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No