Supra-Inguinal Fascia Iliaca Block in Older-Old Patients for Hip Fractures: A Retrospective Study

Abstract

Background Pain management in hip fracture patients is of great importance for reducing postoperative morbidity and mortality. Multimodal techniques, including peripheral nerve blocks, are preferred for postoperative analgesia. Older-old hip fracture patients with high ASA scores are highly sensitive to the side effects of NSAIDs and opioids. Our aim was to investigate the effectiveness of the recently popularized Supra-Inguinal Fascia Iliaca Block (SIFIB) in this population.Methods Forty-one ASA III...IV patients who underwent SIFIB...+...PCA (G-SIFIB) or PCA alone (Group Control: GC) after general anesthesia were evaluated retrospectively. In addition to 24-hour opioid consumption, Visual Analog Scale (VAS) scores, opioid-related side effects, block-related complications, and length of hospital stay were compared.Results Twenty-two patients in G-SIFIB and 19 patients in GC were evaluated. The postoperative 24-hour opioid consumption was lower in G-SIFIB than in GC (p<0.001). There was a statistically significant reduction in VAS scores at the postoperative 1(st), 3(rd), and 6(th) hours at rest (p<0.001) and during movement (p<0.001 for the 1(st) and 3(rd) hours, and p=0.02 for the 6(th) hour) in G-SIFIB compared to GC. There was no difference in pain scores at the 12(th) and 24(th) hours postoperatively. While there was no difference between the groups in terms of other side effects, respiratory depression was significantly higher in GC than in G-SIFIB (p=0.01).Conclusion The SIFIB technique has a significant opioid-sparing effect and thus reduces opioid-related side effects in the first 24 hours after hip fracture surgery in older-old patients.