A randomised, controlled, double blind, non-inferiority trial of ultrasound-guided fascia iliaca block vs. spinal morphine for analgesia after primary hip arthroplasty

Kearns, R., Macfarlane, A. , Grant, A., Puxty, K. , Harrison, P., Shaw, M., Anderson, K. and Kinsella, J. (2016) A randomised, controlled, double blind, non-inferiority trial of ultrasound-guided fascia iliaca block vs. spinal morphine for analgesia after primary hip arthroplasty. Anaesthesia, 71(12), pp. 1431-1440. (doi:10.1111/anae.13620) (PMID:27714758)

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Abstract

We performed a single centre, double blind, randomised, controlled, non-inferiority study comparing ultrasound-guided fascia iliaca block with spinal morphine for the primary outcome of 24-h postoperative morphine consumption in patients undergoing primary total hip arthroplasty under spinal anaesthesia with levobupivacaine. One hundred and eight patients were randomly allocated to receive either ultrasound-guided fascia iliaca block with 2 mg.kg−1 levobupivacaine (fascia iliaca group) or spinal morphine 100 μg plus a sham ultrasound-guided fascia iliaca block using saline (spinal morphine group). The pre-defined non-inferiority margin was a median difference between the groups of 10 mg in cumulative intravenous morphine use in the first 24 h postoperatively. Patients in the fascia iliaca group received 25 mg more intravenous morphine than patients in the spinal morphine group (95% CI 9.0–30.5 mg, p < 0.001). Ultrasound-guided fascia iliaca block was significantly worse than spinal morphine in the provision of analgesia in the first 24 h after total hip arthroplasty. No increase in side-effects was noted in the spinal morphine group but the study was not powered to investigate all secondary outcomes.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Harrison, Dr Paul and Grant, Dr Andrew and MacFarlane, Dr Alan and Kinsella, Professor John and Shaw, Mr Martin and Puxty, Dr Kathryn and Kearns, Dr Rachel
Authors: Kearns, R., Macfarlane, A., Grant, A., Puxty, K., Harrison, P., Shaw, M., Anderson, K., and Kinsella, J.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Anaesthesia
Publisher:Wiley
ISSN:0003-2409
ISSN (Online):1365-2044
Published Online:07 October 2016
Copyright Holders:Copyright © 2016 Wiley
First Published:First published in Anaesthesia 71(12):1431-1440
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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