Fascia iliaca compartment block versus no block for pain control after lower limb surgery: a meta-analysis

The analgesic effect of fascia iliaca compartment block (FICB) versus no block (NB) after lower limb surgery (LLS) is still controversial, so we performed this meta-analysis.

By searching the PubMed, Embase and the Cochrane Library (last update by July 20, 2017), randomized controlled trials comparing the analgesic effect of FICB versus NB in patients receiving LLS were identified. The primary outcome was the pain scores at 4, 12, and 24 h after LLS. The dosage of morphine at 24 h was also collected. The side effect of anesthesia was assessed according to the occurrence rate of postoperative nausea and vomiting.

Data from 7 clinical trials that included 508 patients were summarized. The results showed that patients receiving FICB had lower pain scores at 4 h (mean difference [MD]=-1.17; 95% CI=-2.30 to -0.05; P=0.041), 12 h (MD=-0.41; 95% CI=-0.76 to -0.05; P=0.026) and 24 h (MD=-0.96; 95% CI=-1.77 to -0.15; P=0.020) after LLS. Besides, FICB could reduce the dosage of morphine at 24 h (MD=-2.06; 95% CI=-3.82 to -0.30; P=0.022) and the incidence of postoperative nausea and vomiting (relative risk rate=0.44, 95% CI=0.24-0.80, P=0.008).

Compared with NB, FICB is an effective and safe method for alleviating the pain after LLS. More high-quality randomized controlled trials are needed to confirm this finding.