Suprainguinal fascia iliaca block vs. multimodal analgesia for pain control following hip hemiarthroplasty

Abstract

Background: Bipolar hip hemiarthroplasty is the most common surgical intervention for femoral neck fractures. Optimum postoperative analgesia with the least complications is critical in enhancing functional rehabilitation. In this study, an evaluation of the effectiveness of SIFI block under ultrasound guidance in relation to multimodal intravenous analgesia in controlling postoperative pain in bipolar hip hemiarthroplasty was conducted.

Methodology: Sixty subjects were randomly assigned to receive multimodal analgesia or a SIFI block. Total consumption of morphine in 24 postoperative hours, duration to first request for rescue analgesia, pain evaluation, duration to ambulation, and complications' rate, respectively, were secondary and principal measured outcomes in both groups.

Results: Consumption of morphine in SIFI group was significantly less (P < 0.001), and request for rescue analgesia in SIFI group developed much later (P < 0.001). Scores for pain in SIFI group were consistently less when compared with the multimodal group (P < 0.001). Duration to ambulation, however, did not exhibit any significant variation between groups (P = 0.591). Application of SIFI block showed a reduced postoperative complications' incidence.

Conclusion: The study concludes that SIFI under ultrasound guidance yields better analgesia, less consumption of opiates, and fewer complications when compared with multimodal analgesia. These observations promote its use as a strong form of analgesia in bipolar hip hemiarthroplasty cases.

Keywords: Suprainguinal fascia iliaca; Multimodal analgesia; Hip hemiarthroplasty; Postoperative complications; Morphine consumption

Citation: Fahmy NMA, Zaki GFS, Shabana TSS, Ali SHM. Suprainguinal fascia iliaca block vs. multimodal analgesia for pain control following hip hemiarthroplasty. Anaesth. pain intensive care 2025;30(2):147-159. DOI: 10.35975/apic.v30i2.3120

Received: March 10, 2025; Revised: August 28, 2025; Accepted: February 02, 2026