Comparison Fascia Iliaca Block between 30 and 40 ml of 0.33% Bupivacaine in 48-hour Postoperative Morphine Consumption for Hip Surgery in Elderly Patients

Abstract

Background: Fascia iliaca block for hip surgery has benefit in pain control and early ambulation. Previous cadaveric study found high volume of fascia iliaca block covered all nerves in fascia iliaca plane. Objectives: To compare the volume of 30 ml and 40 ml of fascia iliaca block undergoing hip surgery in elderly patients. Methods: A prospective randomized placebo-controlled study in 3 groups of patients (n=51;17 per group). Group P; normal saline 30 ml (placebo), group A; 0.33% bupivacaine 30 ml and group B; 0.33% bupivacaine 40 ml. Primary outcome was 48-hour postoperative morphine consumption from patient-controlled analgesia. Secondary outcomes were 48-hour postoperative numerical rating scale, time of first rescue analgesia and time of first sitting without pain. Results: 48-hour morphine consumption in group A and B(14 and 12 mg) were lower than group P(28 mg) significantly(p<0.001). Time of first sitting without pain in group A and B were significantly lower (p<0.001). Numerical rating scale were significantly different (p=0.043) and lower in group B than group P (p=0.01656) after pair comparison. Conclusion: Fascia iliaca block for hip surgery in elderly patients is effective in reducing postoperative morphine consumption and early ambulation. Fascia iliaca block 40 ml decreases postoperative pain.