Among the clinically relevant regional nerve blocks for primary THA, a single high quality randomized clinical trial compared a fascia iliaca compartment block and peri-articular local anesthetic infiltration, and a single high quality randomized clinical trial compared a lumbar plexus nerve block and peri-articular local anesthetic infiltration.[16, 17] Both randomized clinical trials demonstrated peri-articular local anesthetic infiltration is equivalent to either a fascia iliaca compartment or lumbar plexus nerve block regarding postoperative pain and opioid consumption.[16, 17] Peri-articular local anesthetic infiltration should be considered first before resorting to a regional nerve block in primary THA because the additional cost and risk associated with a regional nerve block do not offer any additional benefit compared to peri-articular local anesthetic infiltration. Therefore, we recommend the use of peri-articular local anesthetic infiltration over the routine use of regional nerve blocks following primary THA. However, if a patient‘s circumstance does warrant a regional nerve block, we recommend use of a fascia iliaca compartment block.
- Fahs AM, Koueiter DM, Kurdziel MD, Huynh KA, Perry CR, Verner JJ. Psoas Compartment Block vs Periarticular Local Anesthetic Infiltration for Pain Management After Anterior Total Hip Arthroplasty: A Prospective, Randomized Study. The Journal of arthroplasty 33(7): 2192-2196, 2018 DOI: 10.1016/j.arth.2018.02.052.
- Gasanova I, Alexander JC, Estrera K, Wells J, Sunna M, Minhajuddin A, Joshi GP. Ultrasound-guided suprainguinal fascia iliaca compartment block versus periarticular infiltration for pain management after total hip arthroplasty: a randomized controlled trial. Reg Anesth Pain Med 44(2): 206-211, 2019 DOI: 10.1136/rapm-2018-000016.