Comparison of Analgesic Efficacy of Suprainguinal Fascia Iliaca and Quadro-iliac Blocks in Hip Fracture Surgery

Condition(s) studied

Investigational drug(s) / intervention(s)

Suprainguinal Fascia Iliaca Block: the area between the iliacus muscle and the fascia iliaca will be reached at the level of the anterior superior iliac spine, proximal to the inguinal ligament. Hydrodissection will be performed with 2 mL of saline, followed by the injection of 40 mL of 0.25% bupivacaine.

Quadro-Iliac Plane Block: At the level of the L3 vertebra, the probe will be placed just lateral to the spinous process to visualize the erector spinae, quadratus lumborum, and psoas major muscles.

Study summary

Hip fractures are common in the elderly and are associated with significant morbidity and mortality. Effective early analgesia is crucial for facilitating mobilization, reducing pulmonary complications, and improving overall outcomes. Although opioids are traditionally used for postoperative pain management, their adverse effects have led to increased interest in multimodal analgesia, particularly peripheral nerve blocks.

The suprainguinal fascia iliaca block (SIFI) is a modified technique that allows wider spread of local anesthetic, providing more effective blockade of the femoral, obturator, and lateral femoral cutaneous nerves. The quadro-iliac plane block (QIPB), a recently described interfascial block, is performed at the level of the anterior superior iliac spine and may also affect branches of the lumbar and sacral plexus.

While both techniques have been shown to provide effective analgesia and reduce opioid consumption, there is no study directly comparing them. Therefore, this study aims to compare the postoperative analgesic efficacy of SIFI and QIPB in patients undergoing hip fracture surgery.

Eligibility

Primary outcome measure(s)

• Postoperative Pain Assessed by Numeric Rating Scale (NRS) — 24 hours postoperatively
  Postoperative pain will be evaluated using the Numeric Rating Scale (NRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.

Trial sites (1)

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