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Continuous Fascia Iliaca Compartment Block Improves Outcomes in Hip Fragility Fracture Patients.

Matthew L Mitchell¹, Shahad Alassal², Gregory Panza³

¹Department of Anesthesiology, Integrated Anesthesia Associates, Bone and Joint Institute, Hartford Hospital, Hartford, USA.

|October 20, 2025

Summary

Continuous fascia iliaca compartment block (CFICB) is safe for elderly hip fracture patients, significantly reducing pain and opioid use. However, it did not decrease postoperative delirium incidence.

Keywords:

fascia iliaca compartment block fragility hip fracture opioid reduction post-op pain management postoperative delirium

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Area of Science:

Anesthesiology
Geriatric Medicine
Orthopedic Surgery

Background:

Hip fragility fractures (HFF) are common in elderly patients, leading to significant postoperative pain and complications.
Regional anesthesia (RA), such as continuous fascia iliaca compartment block (CFICB), is explored for pain management in HFF repair.
Optimizing pain control and reducing delirium are critical for improving outcomes in this vulnerable population.

Purpose of the Study:

To evaluate the safety and efficacy of CFICB in reducing postoperative pain, opioid consumption, and delirium in elderly patients undergoing HFF repair.
To compare outcomes between patients receiving CFICB and those receiving no regional anesthesia.
To assess secondary outcomes including length of stay and postoperative complications.

Main Methods:

Retrospective cohort study of patients aged ≥65 years undergoing HFF repair.
Comparison between patients who received CFICB and a control group who received no RA.
Analysis of postoperative pain scores, opioid use, delirium incidence, and other clinical outcomes.

Main Results:

CFICB group showed significantly lower pain scores (rest, activity, maximum) and opioid consumption compared to controls (P < 0.05).
Post-anesthesia care unit (PACU) length of stay was longer in the CFICB group (P < 0.05).
No significant difference in the overall incidence of postoperative delirium between groups; baseline dementia predicted delirium.

Conclusions:

CFICB is a safe regional anesthesia technique for elderly patients undergoing HFF surgical repair.
CFICB effectively reduces postoperative pain and opioid requirements in this population.
Further research is needed to optimize anesthetic regimens and improve additional outcomes, particularly delirium, in elderly HFF patients.