OP043 An iliopsoas plane block reduces opioid consumption after hip arthroscopy by 56% without compromising ambulation. a double blind, randomized trial

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Background and Aims

Hip arthroscopy is associated with pain due to the intraoperative stretching of the hip capsule and the surgical intervention. Pain is predominantly generated by nociceptors in the anterior part of the hip joint capsule, which is innervated by the femoral nerve. Pain can be relieved by a femoral nerve block that impedes ambulation or opioids causing nausea and vomiting. An iliopsoas plane block (IPB) anesthetizes the hip joint capsule without compromising the ability to ambulate

Methods

In a randomized double-blind trial approved by the Central Denmark Region Committee on Health Research Ethics 50 patients scheduled for hip arthroscopy in general anesthesia were randomized to active or placebo IPB (figure 1). The primary outcome was IV morphine equivalent consumption the first three postoperative hours in the post anesthesia care unit (PACU). Secondary outcomes were pain (NRS 0-10), nausea and ability to ambulate.

Results

The IV opioid consumption was reduced by 56% in the active IPB group versus the placebo IPB group, 10.4 mg (5.5) versus 23.8 mg (9.6) respectively (p<0.001) – see figure 2/table 1. No intergroup differences were observed regarding pain, nausea or ability to ambulate during the three-hour follow-up (table 1).

Conclusions

An IPB reduced the postoperative opioid consumption by 56% after hip arthroscopy in this randomized double blind trial.