Comparative study of the infrainguinal and suprainguinal approaches of fascia iliaca compartment block for postoperative analgesia in hip surgeries

• Author Details:   
• Pallavi Ahluwalia ^*
• Sangeeth S Kumar

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Background: Patients with hip fractures often experience severe pain, making effective analgesic treatment crucial in the postoperative period. Fascia iliaca compartment block (FICB) is commonly used as part of a multimodal approach to reduce intravenous analgesic requirements.

Materials and Methods: This study compared the analgesic efficacy of two FICB techniques. Eighty patients were randomized to receive FICB via the suprainguinal approach (Group S) or infrainguinal approach (Group I) with 30 mL of 0.25% bupivacaine. Emergency analgesia included 50 mg of tramadol. Demographic profiles, time to first rescue analgesic, visual analogue scale (VAS) scores, and adverse events such as nausea, vomiting, hypotension, and bradycardia were recorded.

Results: Time to first rescue analgesic was significantly longer in Group S (284.89 ± 6.09 minutes) compared to Group I (189.01 ± 12.78 minutes; p=0.009). Postoperative tramadol consumption was significantly lower in Group S at 6, 12, and 24 hours, with cumulative consumption (14.15 ± 3.09 vs. 24.15 ± 8.96 mg; p=0.011) also reduced. Group S demonstrated superior VAS score reductions at 4–6 hours post-block compared to Group I, but there was no significant difference in VAS at 12 and 24 hours.

Conclusion: The suprainguinal FICB approach provides superior analgesic efficacy and lower tramadol consumption within 24 hours compared to the infrainguinal approach.

Keywords: Fascia iliaca compartment block, Infrainguinal access, Postoperative analgesia, Suprainguinal approach, VAS score.