The efficacy of fascia iliaca compartment block for pain control after total hip arthroplasty: a meta-analysis

Xiao-Yan Zhang, Jian-Bao Ma, Xiao-Yan Zhang, Jian-Bao Ma

Abstract

Purpose: Fascia iliaca compartment block (FICB) provides an analgesic option for total hip arthroplasty (THA) patients. The evidence supporting FICB is still not well established. The purpose of this meta-analysis was to assess FICB for pain control in THA patients.

Methods: PubMed, Embase, Cochrane Library, and Chinese Wanfang database were interrogated from their inceptions to December 15, 2018. We included randomized controlled studies reported as full text, those published as abstracts only, and unpublished data, if available. Data were independently extracted by two reviewers and synthesized using a random-effects model or fixed-effects model according to the heterogeneity.

Results: A total of eight RCTs were finally included for meta-analysis. Compared with placebo, FICB could significantly reduce VAS pain scores at 1-8 h (WMD = - 0.78, 95% CI [- 1.01, - 0.56], P = 0.000), 12 h (WMD = - 0.69, 95% CI [- 1.22, - 0.16], P = 0.011), and 24 h (WMD = - 0.46, 95% CI [- 0.89, - 0.02], P = 0.039). Compared with the control group, FICB could significantly decrease the occurrence of nausea and length of hospital stay (P < 0.05). There was no significant difference between the VAS pain score at 48 h and risk of fall between the FICB and the control groups (P > 0.05).

Conclusions: FICB could be used to effectively reduce pain intensity up to 24 h, total morphine consumption, and length of hospital stay in THA patients. Optimal strategies of FICB need to be studied in the future.

Keywords: Fascia iliaca compartment block; Meta-analysis; Total hip arthroplasty.

Conflict of interest statement

Ethics approval and consent to participate

Not applicable. This meta-analysis does not involve research on humans.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
Risk of bias summary
Fig. 3
Fig. 3
Risk of bias graph
Fig. 4
Fig. 4
Forest plot for the comparison of VAS at 1–8 h (a), VAS at 12 h (b), VAS at 24 h (c), and VAS at 48 h (d) between the FICB group and the control group
Fig. 5
Fig. 5
Forest plot for the comparison of total morphine consumption between the FICB group and the control group
Fig. 6
Fig. 6
Forest plot for the comparison of the length of hospital stay between the FICB group and the control group
Fig. 7
Fig. 7
Forest plot for the comparison of risk of nausea between the FICB group and the control group
Fig. 8
Fig. 8
Forest plot for the comparison of the occurrence of fall between the FICB group and the control group
Fig. 9
Fig. 9
Funnel plot for the comparison of the VAS at 1–8 h between the FICB group and the control group
Fig. 10
Fig. 10
Begg’s test for the comparison of the VAS at 1–8 h between the FICB group and the control group
Fig. 11
Fig. 11
Sensitivity analysis of the VAS at 6–8 h between the FICB group and the control group

References

    1. Sun L, Zhu X, Zou J, Li Y, Han W. Comparison of intravenous and oral acetaminophen for pain control after total knee and hip arthroplasty: a systematic review and meta-analysis. Medicine. 2018;97(6):e9751. doi: 10.1097/MD.0000000000009751.
    1. Liu G, Gong M, Wang Y, Xiang Z. Effect of methylprednisolone on pain management in total knee or hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Clin J Pain. 2018;34(10):967–974.
    1. Lindestrand AG, Christiansen ML, Jantzen C, van der Mark S, Andersen SE. Opioids in hip fracture patients: an analysis of mortality and post hospital opioid use. Injury. 2015;46(7):1341–1345. doi: 10.1016/j.injury.2015.04.016.
    1. Aghayev E, Teuscher R, Neukamp M, Lee EJ, Melloh M, Eggli S, Roder C. The course of radiographic loosening, pain and functional outcome around the first revision of a total hip arthroplasty. BMC Musculoskelet Disord. 2013;14:167. doi: 10.1186/1471-2474-14-167.
    1. Guay J, Johnson RL, Kopp S. Nerve blocks or no nerve blocks for pain control after elective hip replacement (arthroplasty) surgery in adults. Cochrane Database Syst Rev. 2017;10:Cd011608.
    1. Eyi YE, Arziman I, Kaldirim U, Tuncer SK. Fascia iliaca compartment block in the reduction of dislocation of total hip arthroplasty. Am J Emerg Med. 2014;32(9):1139. doi: 10.1016/j.ajem.2014.06.007.
    1. Desmet M, Vermeylen K, Van Herreweghe I, Carlier L, Soetens F, Lambrecht S, Croes K, Pottel H, Van de Velde M. A longitudinal supra-inguinal fascia iliaca compartment block reduces morphine consumption after total hip arthroplasty. Reg Anesth Pain Med. 2017;42(3):327–333. doi: 10.1097/AAP.0000000000000543.
    1. Perry CR, Jr, Fahs AM, Kurdziel MD, Koueiter DM, Fayne RJ, Verner JJ. Intraoperative psoas compartment block vs preoperative fascia iliaca block for pain control after direct anterior total hip arthroplasty: a randomized controlled trial. J Arthroplast. 2018;33(6):1770–1774. doi: 10.1016/j.arth.2018.01.010.
    1. Aprato A, Audisio A, Santoro A, Grosso E, Devivo S, Berardino M, Masse A. Fascia-iliaca compartment block vs intra-articular hip injection for preoperative pain management in intracapsular hip fractures: a blind, randomized, controlled trial. Injury. 2018;49(12):2203–2208. doi: 10.1016/j.injury.2018.09.042.
    1. Knobloch K, Yoon U, Vogt PM. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and publication bias. J Craniomaxillofac Surg. 2011;39(2):91–92. doi: 10.1016/j.jcms.2010.11.001.
    1. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2.
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–560. doi: 10.1136/bmj.327.7414.557.
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–634. doi: 10.1136/bmj.315.7109.629.
    1. Badica IC, Pavelescu D, Badica L, Barbilian R, Grintescu I. The efficacy of fascia iliaca compartment block (FICB) for postoperative analgesia after hip arthroplasty (HA) Reg Anes Pain Med. 2010;35(5):E80.
    1. Shariat AN, Hadzic A, Xu D, Shastri U, Kwofie K, Gandhi K, McCally CM, Gratenstein K, Vandepitte C, Gadsden J, et al. Fascia lliaca block for analgesia after hip arthroplasty: a randomized double-blind, placebo-controlled trial. Reg Anesth Pain Med. 2013;38(3):201–205. doi: 10.1097/AAP.0b013e31828a3c7c.
    1. Stevens M, Harrison G, McGrail M. A modified fascia iliaca compartment block has significant morphine-sparing effect after total hip arthroplasty. Anaesth Intensive Care. 2007;35(6):949–952.
    1. Bang S, Chung J, Jeong J, Bak H, Kim D. Efficacy of ultrasound-guided fascia iliaca compartment block after hip hemiarthroplasty: a prospective, randomized trial. Medicine. 2016;95(39):e5018. doi: 10.1097/MD.0000000000005018.
    1. Goitia Arrola L, Telletxea S, Martinez Bourio R, Arizaga Maguregui A, Aguirre Larracoechea U. Fascia iliaca compartment block for analgesia following total hip replacement surgery. Rev Esp Anestesiol Reanim. 2009;56(6):343–348. doi: 10.1016/S0034-9356(09)70406-2.
    1. Deniz S, Atim A, Kurklu M, Cayci T, Kurt E. Comparison of the postoperative analgesic efficacy of an ultrasound-guided fascia iliaca compartment block versus 3 in 1 block in hip prosthesis surgery. Agri. 2014;26(4):151–157. doi: 10.5505/agri.2014.76993.
    1. Lei G, Wu W, Li P, Zhang L, Wu G. The efficacy of ultrasound-guided continuous iliac fascia space block for postoperative analge-sia in elderly patients undergoing total hip replacement. Prac J Clin Med. 2016;13(2):114–117.
    1. Zhang P, Li J, Song Y, Wang X. The efficiency and safety of fascia iliaca block for pain control after total joint arthroplasty: a meta-analysis. Medicine. 2017;96(15):e6592. doi: 10.1097/MD.0000000000006592.
    1. Fei D, Ma LP, Yuan HP, Zhao DX. Comparison of femoral nerve block and fascia iliaca block for pain management in total hip arthroplasty: a meta-analysis. Int J Surg. 2017;46:11–13. doi: 10.1016/j.ijsu.2017.08.008.
    1. Steenberg J, Moller AM. Systematic review of the effects of fascia iliaca compartment block on hip fracture patients before operation. Br J Anaesth. 2018;120(6):1368–1380. doi: 10.1016/j.bja.2017.12.042.
    1. McGraw-Tatum MA, Groover MT, George NE, Urse JS, Heh V. A prospective, randomized trial comparing liposomal bupivacaine vs fascia iliaca compartment block for postoperative pain control in total hip arthroplasty. J Arthroplast. 2017;32(7):2181–2185. doi: 10.1016/j.arth.2017.02.019.
    1. Mostafa SF, Eid GM, Elkalla RS. Patient-controlled fascia iliaca compartment block versus fentanyl patient-controlled intravenous analgesia in patients undergoing femur fracture surgery ☆. Egypt J Anal Chem. 2018;34(1):9–13.

Source: PubMed

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