Combined block of the femoral and lateral femoral cutaneous nerves under ultrasound for postoperative analgesia in patients undergoing hip surgery: A double blind randomized trial

Background: Inadequate pain management of post-operative pain of patients undergoing hip surgery can result in morbidity and mortality complications. Anatomically, pain resulted from the incision site innervation (Lateral femoral cutaneous nerve) and the hip joint innervation mainly the femoral nerve. Adding femoral nerve blockade to the multimodal regimen for postoperative pain control after hip surgery has been described. Methods: all 31 patients included in the study received preoperatively combined FN and LFCN block with Normal Saline 0, 9% (group I) or bupivacaine 0.5% (group II) randomly by using a previously generated continuous randomization list kept in a closed envelope. Pain control regimen consisted of Perfalgan 1g IV every 6 hours systematically and Dolosal 50 mg IM every 6 hours if needed (i.e. VAS > 4). Pain level was measured by using Visual Analogue Scale (VAS) for the first 24 hours. Time to the first request of analgesia and the total dose of dolosal were calculated. Results: The number of patients who requested narcotics was significantly higher in group I (8) than group II (3), P=0,044; the total dose of dolosal used was significantly higher in group I (50 mg) than group II (9,375mg), P=0,0058. Time to the first request for analgesia was significantly lower in group I (6hrs ± 5,12) as compared to Group II (21.3 hrs ± ٣١,٢), P =0,043. Conclusion: In conclusion, FN and LFCN block when added to the standard regimen for postoperative pain management after hip surgery had a benefit in decreasing pain scores as well as opioid consumption.