Research Articles | Challenge Journal of Perioperative Medicine

Comparison of the postoperative analgesic efficacy of ultrasound-guided suprainguinal fascia iliaca block applied with two different concentrations of bupivacaine in patients undergoing hip surgery under spinal anesthesia

Kadem Koc, Busra Burcu Kucuk Ordulu, Ramazan Burak Ferli, Busra Yesilyurt, Nizamettin Guzel, Serkan Tulgar, Mustafa Suren

View Counter: Abstract | 263 times | ‒ Full Article | 132 times |

Full Text:



Aim:  Management of postoperative pain in hip surgeries is important for the quality of recovery. When regional anesthesia techniques are added to the multimodal analgesia plan, they increase the effectiveness of the analgesia plan. Supra-inguinal fascia iliaca block (SIFIB) is a technique that has been reported to be effective in hip surgery but requires the use of high-volume local anesthetics. Our aim in this retrospective study is to investigate the efficacy of local anesthetic in SIFIB when administered at a concentration lower than the conventional concentration.

Material and Methods: The files of the patients who underwent hip hemiarthroplasty were planned to be evaluated retrospectively. Patients were grouped according to the bupivacaine concentration used in SIFIB (0.25% vs. 0.20%) and statistically evaluated in terms of morphine requirement, pain scores, and time to first analgesic.

Results: There was no significant difference between the groups in terms of NRS score and cumulative morphine consumption at the 3rd, 6th, 12th, 18th, and 24th hours (p>0.05). When compared the first analgesia requirement times, there was no significant difference between Groups (p>0.05).

Conclusion: A single shot SIFIB administered at a concentration of 0.20% also has analgesic properties, as do the conventional concentration of SIFIB containing 0.25% bupivacaine.


suprainguinal fascia iliaca block; hip surgery; postoperative analgesia; bupivacaine


Neuman MD, Feng R, Carson JL et al. Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults. N Engl J Med. 2021;25;385(22):2025–35.

Zhang C. Hip Surgery: A Practical Guide. Springer Nature; 2020. 315 p.

Ursavaş FE, Yaradılmış YU. Relationship Between Pain Beliefs and Postoperative Pain Outcomes After Total Knee and Hip Replacement Surgery. J Perianesth Nurs. 2021;36(2):187–93.

Hebbard P, Ivanusic J, Sha S. Ultrasound-guided supra-inguinal fascia iliaca block: a cadaveric evaluation of a novel approach. Anaesthesia. 2011;66(4):300–5.

Bansal K, Sharma N, Singh MR, Sharma A, Roy R, Sethi S. Comparison of suprainguinal approach with infrainguinal approach of fascia iliaca compartment block for postoperative analgesia. Indian J Anaesth. 2022;66(Suppl 6):S294–9.

Zheng T, Hu B, Zheng CY, Huang FY, Gao F, Zheng XC. Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block. BMC Anesthesiol. 2021;10;21(1):1–8.

Nassar H, Hasanin A, Sewilam M, Ahmed H, Abo-Elsoud M, Taalab O, Rady A, Zoheir HA. Transmuscular Quadratus Lumborum Block versus Suprainguinal Fascia Iliaca Block for Hip Arthroplasty: A Randomized, Controlled Pilot Study. Local Reg Anesth. 2021;20;14:67–74.

Jadon A, Mohsin K, Sahoo RK, Chakraborty S, Sinha N, Bakshi A. Comparison of supra-inguinal fascia iliaca versus pericapsular nerve block for ease of positioning during spinal anaesthesia: A randomised double-blinded trial. Indian J Anaesth. 2021;65(8):572–8.

Tian Y, Zhan Y, Liu K, Bu S, Tian Y, Xiong C, Shen J. Analgesic effects of different concentrations of ropivacaine in transversalis fascia plane block during laparotomy. BMC Anesthesiol. 2022;26;22(1):54.

Tulgar S, Selvi O, Senturk O, Serifsoy TE, Sanel S, Meydaneri S. Evaluation of analgesic regimens in total knee arthroplasty, retrospective study. North Clin Istanb. 2017;25;4(2):124–30.

Baliuliene V, Macas A, Rimaitis K. The optimal concentration of bupivacaine and levobupivacaine for labor pain management using patient-controlled epidural analgesia: a double-blind, randomized controlled trial. Int J Obstet Anesth. 2018;35:17–25.

Vermeylen K, Desmet M, Leunen I, Soetens F, Neyrinck A, Carens D, Caerts B, Seynaeve P, Hadzic A, Van de Velde M. Supra-inguinal injection for fascia iliaca compartment block results in more consistent spread towards the lumbar plexus than an infra-inguinal injection: a volunteer study. Reg Anesth Pain Med 2019;44:483-91

Kantakam P, Maikong N, Sinthubua A, Mahakkanukrauh P, Tran DQ, Leurcharusmee P. Cadaveric investigation of the minimum effective volume for ultrasound-guided suprainguinal fascia iliaca block. Reg Anesth Pain Med. 2021;46(9):757–62.

Vermeylen K, Leunen IUltrasound-guided suprainguinal fascia iliaca compartment block versus periarticular infiltration for pain management after total hip arthroplasty: a randomized controlled trialRegional Anesthesia & Pain Medicine 2019;44:815-816.


  • There are currently no refbacks.