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

Abstract

Purpose: To assess the effect of fascia iliaca compartment block (FICB) on pain control and morphine consumption in patients with total hip arthroplasty (THA).

Methods: We searched databases (PubMed, Embase, Cochrane Library) for eligible randomized controlled trials (RCTs) published prior to September 12, 2018. We only included THA patients who received FICB versus placebo for pain control. Risk ratios (RRs), standard mean differences (SMD) and 95% confidence intervals (CI) were determined. Stata 12.0 was used for the meta-analysis.

Results: A total of 326 THA patients from 7 RCTs were subjected to meta-analysis. Overall, FICB was associated with lower VAS scores at 1-8 h and 12 h compared with placebo (P < 0.05). However, there was no significant difference between VAS at 24 h (SMD = -0.56, 95% CI [-1.42, 0.31], P = 0.206) and 48 h after THA (SMD = -0.82, 95% CI [-2.07, 0.44], P = 0.204). Compared with the control group, FICB significantly decreased the occurrence of nausea (RR = 0.41, 95% CI 0.25 to 0.69, P = 0.010; I² = 0.0%). There was no significant difference in the risk of falls between the FICB and control groups (P > 0.05).

Conclusions: FICB has a beneficial role in reducing pain intensity and morphine consumption after THA. Moreover, FICB has morphine-sparing effects when compared with a control group. More high-quality RCTs are needed to identify the optimal technique and volume of injectate for FICB.

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