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Ultrasound-Guided Suprainguinal Versus Infrainguinal Fascia Iliaca Compartment Block for Postoperative Analgesia
Vinod K Srivastava1, Adarsh K Singh1, Neel K Mishra1
1Anesthesiology, King George's Medical University, Lucknow, IND.
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.
