Comparative study between ultrasound-guided lumbar erector spinae plane block and fascia iliaca compartment block for postoperative analgesia after total hip arthroplasty

Abstract

Background: Optimized pain therapy following total hip arthroplasty (THA) is associated with important benefits, including more rapid rehabilitation and decreased risk of postoperative consequences. The purpose of this work was to contrast the pain-relieving effectiveness of ultrasound-guided Lumbar Erector Spinae Plane block (L-ESPB) against Fascia Iliaca Compartment Block (FICB) among individuals who were going to have THA. Methods: This randomised controlled double-blinded work had been conducted on 75 participants aged from 30 to 75 years old, both genders, I-III physical status based on American Society of Anesthesiologists, scheduled for unilateral hip replacement surgeries utilising spinal anaesthesia. Patients were categorised into three equal groups. Patients obtained spinal anaesthesia alone in the control group plus ipsilateral L-ESPB (30 ml of bupivacaine 0. 25%) in the L-ESPB group and ipsilateral suprainguinal FICB (30 ml of bupivacaine 0. 25%) in the FICB group. Blocks had been conducted at the end of the surgeries guided by ultrasound.Results: The time of first analgesic request revealed a significant delay in both L-ESPB group and FICB group as contrasted to the control group without significant variation among them. A significant increase in total 24-hour postoperative rescue morphine consumption and numerical rating scale in the control group had been existed contrasted to L-ESPB and FICB groups at 4hrs, 8hrs, 12hrs, 18hrs, and 24hrs (p<0.05) without significant variation among them. No patient in the three groups experienced any adverse effect in terms of infection, local anesthetic toxicity, or hematoma.Conclusion: In patients undergoing THA, both L-ESPB and FICB are safe and comparable when used for postoperative analgesia.