1. Fascia iliaca compartment block reduces pain and opioid consumption after total hip arthroplasty: A systematic review and meta-analysis
- Author
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Jie Zhu, Yanping Gao, Ren Sun, and Helian Tan
- Subjects
Arthroplasty, Replacement, Hip ,MEDLINE ,Cochrane Library ,Placebo ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Pain Management ,Fascia ,Adverse effect ,Pain, Postoperative ,Morphine ,business.industry ,Nerve Block ,General Medicine ,Analgesics, Opioid ,Lower Extremity ,Opioid ,030220 oncology & carcinogenesis ,Anesthesia ,Meta-analysis ,030211 gastroenterology & hepatology ,Surgery ,business ,medicine.drug - Abstract
Background Optimal pain management after total hip arthroplasty (THA) remains controversial. We perform a meta-analysis from randomized controlled trials (RCTs) to evaluate the efficacy and safety of fascia iliaca compartment block (FICB) in THA. Methods In this meta-analysis, we conducted electronic searches of Pubmed, Medline, Cochrane library, and Web of Science before February 2019. We collected RCTs to compare FICB and placebo for pain control after THA. The outcome measurements consisted of pain score, opioid consumption, length of hospitalization and postoperative complications. All data analyses were conducted using STATA 13.0. Cochrane Collaboration's tool was adopted to assess the risk of bias. Results Seven RCTs met our inclusion criteria with 165 patients in the FICB groups, and 160 patients in the placebo groups. The present meta-analysis indicated that there were significant differences between the groups in terms of pain score at postoperative 12 h (WMD = −0.285, 95% CI [-0.460, −0.109], P = 0.002) and 24 h (WMD = −0.391, 95% CI [-0.723, −0.059], P = 0.021). FICB was associated with significant superior in opioid consumption at postoperative 12 h (WMD = −5.394, 95% CI [-8.772, −2.016], P = 0.002) and 24 h (WMD = −6.376, 95% CI [-10.737, −2.016], P = 0.004) compared with placebo. No significant difference was identified regarding length of hospitalization (WMD = 0.112, 95% CI [-0.125, 0.350], P = 0.354). Conclusion Fascia iliaca compartment block was effective for pain relief during the early post-operative period after total hip arthroplasty. Meanwhile, it reduced the cumulative morphine consumption and the risk of opioid-related adverse effects.
- Published
- 2019
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