Comparison of Sacral Erector Spinae Plane Block and Supra-Inguinal Fascia Iliaca Block for Analgesia After Hip Fracture Surgery

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

Status

Completed

Conditions

Postoperative Pain Management

Hip Fracture Surgery

Elderly Patients

Regional Anesthesia

Treatments

Procedure: Sacral Erector Spinae Plane Block (SESPB)

Procedure: Supra-inguinal Fascia Iliaca Block (SIFIB)

Study type

Observational

Funder types

Other

Identifiers

NCT07081867

CT-ERHO-AR-BA-01

Details and patient eligibility

About

This study compares the postoperative analgesic effectiveness of Sacral Erector Spinae Plane Block (SESPB) and Supra-Inguinal Fascia Iliaca Block (SIFIB) in patients undergoing hip fracture surgery. Both techniques are regional anesthesia methods aiming to reduce postoperative pain and opioid consumption. The study evaluates pain scores, opioid requirements, mobilization times, and hospital discharge times to determine which block provides more effective pain management in different postoperative periods.

Full description

Hip fractures are common injuries among elderly patients, often resulting in high rates of morbidity and mortality. Effective postoperative pain management plays a critical role in reducing complications such as delayed mobilization, deep vein thrombosis, pneumonia, and prolonged hospitalization.

Regional anesthesia techniques, including Sacral Erector Spinae Plane Block (SESPB) and Supra-Inguinal Fascia Iliaca Block (SIFIB), have gained popularity as part of multimodal analgesia strategies that aim to minimize opioid use and improve postoperative comfort. However, there is limited evidence comparing these two techniques directly.

In this prospective observational study, patients aged 65 and older undergoing hip fracture surgery under spinal anesthesia were included. After obtaining informed consent, patients received either SESPB or SIFIB for postoperative analgesia in addition to the standard anesthetic protocol.

Pain levels were assessed using the Visual Analog Scale (VAS) at 1, 6, 12, and 24 hours after surgery. Additional data such as total opioid consumption within 24 hours, time to first analgesic requirement, mobilization time, and length of hospital stay were recorded.

The results demonstrated that patients who received SIFIB had significantly lower pain scores in the early postoperative period (1st hour), while patients who received SESPB experienced better pain relief in the late postoperative period (24th hour). No significant differences were observed between the groups in terms of total opioid consumption, mobilization time, or hospital stay duration. No complications related to the block procedures were reported.

This study suggests that both SESPB and SIFIB are safe and effective regional anesthesia techniques for postoperative pain management in hip fracture surgeries. The selection between these blocks may be based on the desired onset and duration of analgesia, with SIFIB providing superior early pain control and SESPB offering more prolonged analgesic effects.

Enrollment

77 patients

Sex

All

Ages

65+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients aged 65 years and older
Patients undergoing surgery for hip fractures under spinal anesthesia
Patients who are oriented and cooperative
Patients who have signed an informed consent form

Exclusion criteria

Patients with contraindications for spinal anesthesia
Patients with Alzheimer's disease or dementia, and those who are non-oriented or non-cooperative
Patients with major organ failure (such as heart, liver, or kidney failure)
Patients who decline to participate in the study
Patients classified as American Society of Anesthesiologists (ASA) Physical Status IV or higher
Patients with pathological fractures or bone metastasis