title: Fascia lliaca block for analgesia after hip arthroplasty: a randomized double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  Fascia iliaca block (FIB) is often used to treat pain after total hip arthroplasty (THA), despite a lack of randomized trials to evaluate its efficacy for this indication. The objective of this study was to assess the analgesic benefit of FIB after THA. Our primary hypothesis was administration of FIB decreases the intensity of postoperative pain (numeric rating scale [NRS-11] score) compared with sham block (SB) in patients after THA.
  
  
  METHODS
  After institutional review board approval and informed consent, 32 eligible patients having THA were recruited. In the postoperative care unit, although all patients received intravenous morphine sulfate patient-controlled analgesia, patients reporting pain of 3 or greater on the NRS-11 scale were randomized to receive ultrasound-guided fascia iliaca (30 mL 0.5% ropivacaine) or SB (30 mL 0.9% NaCl) using identical technique, below fascia iliaca. The primary outcome was pain intensity (NRS-11) after FIB.
  
  
  RESULTS
  Thirty-two patients (16 in each group) completed the study; all patients received an FIB. There was no difference in pain intensity (NRS-11 = 5.0 ± 0.6 vs 4.7 ± 0.6, respectively) after FIB versus SB or in opioid consumption (8.97 ± 1.6 vs 5.7 ± 1.6 mg morphine, respectively) between the groups at 1 hour. The morphine consumption after 24 hours was similar in both groups (49.0 ± 29.9 vs 50.4 ± 34.5 mg, P = 0.88, respectively).
  
  
  CONCLUSIONS
  The evidence in these data suggests that the difference in average pain intensity after FIB versus SB was not significant (95% confidence interval, -2.2-1.4 NRS units).
authors.affiliation: Department of Anesthesiology, St Luke's-Roosevelt Hospital Center, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY,USA.
authors.forename: Ali N
authors.initials: AN
authors.lastname: Shariat
authors.forename: Admir
authors.initials: A
authors.lastname: Hadzic
authors.forename: Daquan
authors.initials: D
authors.lastname: Xu
authors.forename: Uma
authors.initials: U
authors.lastname: Shastri
authors.forename: Kwesi
authors.initials: K
authors.lastname: Kwofie
authors.forename: Kishor
authors.initials: K
authors.lastname: Gandhi
authors.forename: Colleen Mitgang
authors.initials: CM
authors.lastname: McCally
authors.forename: Kimberly
authors.initials: K
authors.lastname: Gratenstein
authors.forename: Catherine
authors.initials: C
authors.lastname: Vandepitte
authors.forename: Jeff
authors.initials: J
authors.lastname: Gadsden
authors.forename: Douglas
authors.initials: D
authors.lastname: Unis
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*