Kaye Alan D, Giles Trevor P, O'Brien Emily, Picou Allison M, Thomassen Austin, Thomas Nicholas L, Ahmadzadeh Shahab, Sterritt Jeffrey, Slitzky Matthew A, Buchhanolla Prabandh Reddy, Shekoohi Sahar
Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.
St. George's University School of Medicine, True Blue, West Indies, Grenada.
Curr Pain Headache Rep. 2025 Feb 20;29(1):52. doi: 10.1007/s11916-025-01368-1.
Hip surgeries are commonly associated with significant postoperative pain, which can hinder early mobilization, prolong hospital stays, and increase healthcare costs. Effective pain management in this patient population is crucial to improving outcomes and reducing complications.
Traditional pain control methods, such as systemic opioids, are often associated with adverse effects, including respiratory depression, nausea, and delayed recovery. Regional anesthesia techniques, particularly the suprainguinal fascia iliaca block (SFIB), have gained attention for the potential to provide targeted, long-lasting analgesia with fewer systemic side effects.
This narrative review evaluates efficacy of the SFIB, an effective and safe technique for postoperative pain management in hip surgeries. The fascia iliaca block, initially described as a low-volume alternative to the lumbar plexus block, has evolved, with the suprainguinal approach demonstrating particular promise. By accessing the lumbar plexus and blocking the femoral, obturator, and lateral femoral cutaneous nerves, the SIFIB provides broad analgesia to the hip region. Recent studies have highlighted that, compared to traditional infrainguinal approaches, the suprainguinal technique offers superior spread and more consistent pain control related to its targeted proximity to the inguinal ligament. Consequently, this technique may optimize perioperative pain management and improve functional recovery in patients undergoing hip surgeries.
髋关节手术通常伴有显著的术后疼痛，这可能会阻碍早期活动、延长住院时间并增加医疗成本。在这类患者群体中进行有效的疼痛管理对于改善预后和减少并发症至关重要。
传统的疼痛控制方法，如全身使用阿片类药物，常常伴有不良反应，包括呼吸抑制、恶心和恢复延迟。区域麻醉技术，尤其是腹股沟上髂筋膜阻滞（SFIB），因其有可能提供有针对性的、持久的镇痛且全身副作用较少而受到关注。
本叙述性综述评估了SFIB的疗效，这是一种用于髋关节手术术后疼痛管理的有效且安全的技术。髂筋膜阻滞最初被描述为腰丛阻滞的小剂量替代方法，如今已有所发展，腹股沟上入路显示出特别的前景。通过进入腰丛并阻滞股神经、闭孔神经和股外侧皮神经，SFIB为髋关节区域提供广泛的镇痛。最近的研究强调，与传统的腹股沟下入路相比，腹股沟上技术因其与腹股沟韧带的靶向接近性而具有更好的扩散效果和更一致的疼痛控制。因此，该技术可能会优化髋关节手术患者的围手术期疼痛管理并改善功能恢复。
