Trial reportJournal of orthopaedic surgery and research2026
Efficacy and safety of combined supra-inguinal fascia iliaca compartment block and sacral plexus block versus spinal anesthesia in elderly patients undergoing hip fracture surgery: a prospective randomized controlled trial.
Trial report in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
objectiveThis study aimed to evaluate the efficacy and safety of ultrasound-guided supra-inguinal fascia iliaca compartment block (FICB) combined with sacral plexus block (SPB) compared with spinal anesthesia (SA) in elderly patients undergoing hip fracture surgery.
methodsNinety-eight elderly patients scheduled for hip fracture surgery were enrolled and randomly assigned to two groups: the FICB + SPB group (n = 49, ultrasound-guided supra-inguinal FICB combined with SPB), and the SA group (n = 49, spinal anesthesia). The primary outcome was postoperative pain intensity assessed using visual analog scale (VAS) scores at rest and during passive movement at 3, 6, 12, 18, 24, and 48 h postoperatively. Secondary outcomes included intraoperative hemodynamic parameters, sufentanil consumption, and rescue analgesic use. Anesthesia-related adverse events were also recorded.
resultsVAS scores at rest and during movement were significantly lower at 3, 6, 12, and 18 h postoperatively in the FICB + SPB group (P < 0.05). Moreover, FICB + SPB group had lower sufentanil consumption and a lower proportion of patients requiring rescue analgesia (P < 0.05). The FICB + SPB group exhibited significantly higher blood pressure at skin incision and less intraoperative heart rate variability (P < 0.05). The incidence of nausea, vomiting, hypotension, and constipation was significantly lower in the FICB + SPB group compared to the SA group (P < 0.05).
conclusionUltrasound-guided supra-inguinal FICB combined with SPB provides superior analgesia with fewer adverse events than spinal anesthesia, representing a safe and effective anesthetic alternative for high-risk elderly patients undergoing hip fracture surgery.
trial registrationThe trial was retrospectively registered with the ISRCTN registry (ISRCTN16644322, registration date: 08/12/2025; https://www.isrctn.com/search?q=ISRCTN16644322 ).
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