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Ultrasound-Guided Suprainguinal Versus Infrainguinal Fascia Iliaca Compartment Block for Postoperative Analgesia After Total Knee Replacement: A Prospective Randomized Trial

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: BACKGROUND: Fascia iliaca compartment block (FICB) can be achieved using suprainguinal (SFICB) or infrainguinal (IFICB) approaches. This study compares postoperative analgesia of SFICB and IFICB after total knee replacement (TKR). METHODS: This prospective, randomized, single-blind study was conducted on 60 adult patients undergoing unilateral TKR under spinal anesthesia. Patients were randomly allocated into two groups: Group S received SFICB with 30 mL of 0.25% levobupivacaine with 2 mL (8 mg) dexamethasone, while Group I received IFICB with the same drugs after surgery. The primary outcome variable was 24-hour cumulative tramadol consumption. Secondary outcome variables included pain intensity, complications, hemodynamic variations, and time to first rescue analgesic request. RESULTS: Tramadol consumption was significantly lower with SFICB (86.67±34.57 versus 34.57±33.95 mg, p=0.006). Pain intensity was lower with SFICB after six hours of surgery. Time to first analgesic request was also longer with SFICB (12.83±3.80 versus 10.12±2.98 hours, p=0.003). Time taken for administering the blocks (16.20±2.66 versus 17.17±3.13 minutes), complications, and hemodynamic variations were statistically similar between the groups. CONCLUSION: SFICB provides superior postoperative analgesia compared to IFICB in patients undergoing TKR, with reduced opioid requirement and prolonged analgesia duration.

Source: Cureus

DOI: 10.7759/cureus.84453