DIPB vs. SIFIB for Postoperative Analgesia After Hip Surgery

March 28, 2026 updated by: Fatih Balcı, Sivas Numune Hospital

Comparison of the Effects of Deep Iliacus Plane Block (DIPB) and Suprainguinal Fascia Iliaca Block (SIFIB) on Postoperative Analgesia in Patients Undergoing Hip Surgery: A Randomized Controlled Study

This randomized, double-blind clinical trial aims to compare the effectiveness of the Deep Iliacus Plane Block (DIPB) and the Suprainguinal Fascia Iliaca Block (SIFIB) for postoperative pain control in patients undergoing primary total hip arthroplasty. Effective analgesia after hip surgery is essential for early mobilization, reduction of complications, and improved recovery outcomes.

Seventy patients scheduled for elective hip arthroplasty under spinal anesthesia will be randomly assigned to receive either DIPB or SIFIB at the end of surgery. Postoperative pain scores, opioid consumption, motor block, and block-related complications will be evaluated over a 48-hour period.

The study aims to determine whether DIPB provides superior or comparable analgesia with reduced motor blockade compared to SIFIB, thereby contributing to safer and more comprehensive postoperative pain management in hip surgery patients.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Hip arthroplasty is frequently associated with moderate to severe postoperative pain, which may negatively affect early mobilization, rehabilitation, and overall recovery. Adequate postoperative analgesia is therefore essential to reduce complications such as pulmonary morbidity, thromboembolism, delirium, and prolonged hospital stay.

The hip joint is innervated by both deep articular branches (femoral, obturator, and accessory obturator nerves) and superficial cutaneous branches (femoral nerve and lateral femoral cutaneous nerve). An optimal regional analgesic technique should provide effective blockade of both components. However, currently used techniques often fail to adequately block deep capsular innervation while preserving motor function.

The suprainguinal fascia iliaca block (SIFIB) is widely used in hip surgery and effectively blocks the femoral nerve and lateral femoral cutaneous nerve, providing reliable cutaneous analgesia. Nevertheless, insufficient spread to obturator and accessory obturator nerves may result in inadequate deep joint analgesia. Attempts to overcome this limitation using high-volume injections may increase the risk of quadriceps weakness and motor blockade.

The Deep Iliacus Plane Block (DIPB) is a recently described fascial plane block targeting the deep surface of the iliacus muscle at the level of the anterior inferior iliac spine. Anatomical and preliminary clinical findings suggest that DIPB allows spread of local anesthetic to femoral, lateral femoral cutaneous, and pericapsular articular branches of the hip joint, potentially providing both capsular and cutaneous analgesia with reduced motor impairment. DIPB has therefore been proposed as a hybrid technique combining advantages of existing regional blocks.

This prospective, randomized, controlled, double-blind clinical trial will be conducted at Sivas Numune Hospital. Seventy patients (ASA I-III) scheduled for elective primary total hip arthroplasty under spinal anesthesia will be enrolled and randomly assigned into two groups: the SIFIB group (n=35) and the DIPB group (n=35). Randomization will be performed using a computer-generated sequence.

All patients will receive standardized spinal anesthesia and multimodal systemic analgesia. At the end of surgery, ultrasound-guided SIFIB or DIPB will be performed by an experienced anesthesiologist using 0.25% bupivacaine (30-40 mL, weight-adjusted). Postoperative pain will be assessed using the Numeric Rating Scale (NRS) at rest and during movement at predetermined intervals up to 48 hours. Rescue analgesia with intravenous tramadol will be administered when NRS ≥4, and total opioid consumption will be recorded. Motor blockade will be evaluated using the modified Bromage scale. Block-related complications and adverse events will also be documented.

The primary aim of the study is to compare postoperative pain scores and opioid consumption between DIPB and SIFIB. Secondary outcomes include motor blockade, block-related complications, and overall analgesic effectiveness. The findings of this study are expected to clarify whether DIPB provides superior or comparable analgesia with less motor impairment, thereby contributing to safer and more comprehensive postoperative pain management in hip arthroplasty patients.

Study Type

Interventional

Enrollment (Estimated)

70

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Turkey (Türkiye)
      • Sivas, Turkey (Türkiye)
        • Recruiting
        • Sivas Numune Hospital
        • Contact:
    • Sivas
      • Sivas, Sivas, Turkey (Türkiye), 58050
        • Not yet recruiting
        • Sivas Numune Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients aged ≥18 years
  • ASA physical status I-III
  • Scheduled for elective primary total hip arthroplasty under spinal anesthesia
  • Ability to understand the study procedures and provide informed consent

Exclusion Criteria:

  • Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia
  • Infection at the block application site
  • Hemodynamic instability
  • Known allergy to local anesthetics
  • Pre-existing significant neurological or motor deficits in the lower extremities
  • Cognitive impairment preventing pain assessment
  • Refusal to participate or inability to provide informed consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Suprainguinal Fascia Iliaca Block (SIFIB)
Participants randomized to this arm will receive an ultrasound-guided suprainguinal fascia iliaca compartment block at the end of surgery using 0.25% bupivacaine (30-40 mL, weight-adjusted) for postoperative analgesia following primary total hip arthroplasty.
Procedure: Suprainguinal Fascia Iliaca Block
Ultrasound-guided suprainguinal fascia iliaca compartment block performed at the end of surgery using 0.25% bupivacaine (30-40 mL, weight-adjusted) for postoperative analgesia following primary total hip arthroplasty.
Experimental: Deep Iliacus Plane Block (DIPB)
Participants randomized to this arm will receive an ultrasound-guided deep iliacus plane block at the end of surgery using 0.25% bupivacaine (30-40 mL, weight-adjusted) for postoperative analgesia following primary total hip arthroplasty.
Procedure: Deep Iliacus Plane Block
Ultrasound-guided deep iliacus plane block performed at the end of surgery using 0.25% bupivacaine (30-40 mL, weight-adjusted) for postoperative analgesia following primary total hip arthroplasty.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain intensity
Time Frame: 2, 4, 8, 16, 24, and 48 hours postoperatively
Postoperative pain assessed using the Numeric Rating Scale (NRS; 0 = no pain, 10 = worst pain imaginable) at rest and during movement following total hip arthroplasty.
2, 4, 8, 16, 24, and 48 hours postoperatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Opioid consumption
Time Frame: From the end of surgery to 48 hours postoperatively
Total rescue opioid consumption (intravenous tramadol) administered for postoperative pain management.
From the end of surgery to 48 hours postoperatively
Motor block
Time Frame: 4, 8, 16, 24, and 48 hours postoperatively
Motor blockade assessed using the Modified Bromage Scale (0-3), where higher scores indicate greater motor impairment of the lower extremity following regional anesthesia.
4, 8, 16, 24, and 48 hours postoperatively
Pain during movement
Time Frame: 2, 4, 8, 16, 24, and 48 hours postoperatively
Pain during movement assessed using the Numeric Rating Scale (NRS; 0 = no pain, 10 = worst imaginable pain), where higher scores indicate greater pain intensity.
2, 4, 8, 16, 24, and 48 hours postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sivas Numune Hospital

Investigators

  • Principal Investigator: Fatih BALCI, Sivas Numune Hospital, Department of Anesthesiology and Reanimation

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 27, 2026

Primary Completion (Estimated)

October 1, 2026

Study Completion (Estimated)

November 1, 2026

Study Registration Dates

First Submitted

February 23, 2026

First Submitted That Met QC Criteria

February 27, 2026

First Posted (Actual)

March 5, 2026

Study Record Updates

Last Update Posted (Actual)

April 2, 2026

Last Update Submitted That Met QC Criteria

March 28, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DIPB vs. SIFIB

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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