Effects of Continuous Fascia Iliaca Compartment Block on Early Quality of Recovery After Total Hip Arthroplasty in Elderly Patients: A Randomized Controlled Trial

Abstract

Ying Gao,1 He Li,2 Hongfei Hu,1 Yi Xu,1 Jun Zhou,2 Youtan Liu1 1Department of Anesthesiology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518110, People’s Republic of China; 2Department of Anesthesiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People’s Republic of ChinaCorrespondence: Jun Zhou, Department of Anesthesiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People’s Republic of China, Tel [phone], Email [email protected] Youtan Liu, Department of Anesthesiology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518110, People’s Republic of China, Tel [phone], Email [email protected]: In recent years, patient-centered postoperative quality of recovery has gained attention. This study aimed to assess the influence of ultrasound-guided continuous fascia iliaca compartment block (CFICB) on early quality of recovery in elderly patients after total hip arthroplasty (THA) using the QoR-15 score.Patients and Methods: In this single-center, randomized, prospective study, 60 patients scheduled for unilateral THA were randomized to the CFICB or patient-controlled intravenous analgesia (PCIA) group. The primary outcome was the QoR-15 score. The secondary outcomes were pain score, number of patients requiring rescue analgesics, time of first postoperative ambulation, incidence of postoperative complications, Bromage score, and length of hospital stay.Results: The QoR-15 score was significantly higher in the CFICB group than in the PCIA group at 24 h (P < 0.001) after surgery. However, the QoR-15 score was not significantly different at 48 h (P = 0.074) between the two groups. Pain scores at rest and during movement were lower in the CFICB group than in the PCIA group at 12, 24, and 48 h postoperatively (P < 0.05). There was no difference in the number of patients requiring rescue analgesics, time of first postoperative ambulation, incidence of postoperative complications apart from dizziness, or length of hospital stay between the two groups. In addition, Bromage score of 1 point was reported by four patients in the CFICB group at 24 h (P = 0.048) after THA.Conclusion: In elderly patients following THA, CFICB improved the quality of recovery at 24 h and reduced pain scores compared with PCIA. The time of first postoperative ambulation and length of hospital stay were not significantly affected.Keywords: total hip arthroplasty, elderly, continuous fascia iliaca compartment block, postoperative quality of recovery

Keywords

• total hip arthroplasty
• elderly
• continuous fascia iliaca compartment block
• postoperative quality of recovery