Clinical Outcomes of Fascia Iliaca Compartment Block Combined with Two Different Patient-Controlled Analgesia Regimens for Hip Arthroplasty: A Propensity Score-Matched Retrospective Observational Study.

BACKGROUND: The objective of our study was to retrospectively evaluate the analgesic efficacy, safety, and postoperative recovery of fascia iliaca compartment block combined with patient-controlled intravenous analgesia (FICB + PCIA) versus patient-controlled continuous nerve block analgesia (FICB + PCNB) in patients undergoing hip arthroplasty.

METHODS: This single-center retrospective observational study was based on routinely collected clinical data. There were 136 patients (68 per group) who were selected via stratified random sampling from 1,500 eligible patients who underwent unilateral hip arthroplasty. A 1:1 nearest-neighbor propensity score matching (PSM) was performed with multiple clinical covariates to balance baseline characteristics. Standardized mean difference (SMD) was used to evaluate baseline balance after matching, with SMD less than 0.1 defined as good balance. The primary endpoint was postoperative resting Visual Analog Scale (VAS) scores at six, 12, 24, 48 and 72 hours. The secondary endpoints included 72-hour adverse events, analgesic consumption, lengths of hospital stay, and postoperative complications.

RESULTS: All SMD of baseline covariates were below 0.1 after matching, with no intergroup differences. The VAS scores decreased significantly over time in both groups (Ftime = 22.846, P < 0.001). The FICB + PCNB group had lower overall resting VAS scores (Fgroup = 4.974, P = 0.026), with no significant time-group interaction (Finteraction = 1.728, P = 0.142). The total 72-hour adverse reaction rate was 10.29% in both groups. Opioid consumption was significantly lower in the FICB + PCNB group (P < 0.001). Duration of analgesic pump use, lengths of hospital stay, and complication rates were comparable between groups.

CONCLUSION: The FICB + PCNB provides superior postoperative analgesia and reduces opioid consumption without increasing risks of adverse reactions or complications. It aligns with enhanced recovery after surgery principles and has favorable clinical application value.