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Objective <p>This study aimed to evaluate the efficacy and safety of ultrasound-guided supra-inguinal fascia iliaca compartment block (FICB) combined with sacral plexus block (SPB) compared with spinal anesthesia (SA) in elderly patients undergoing hip fracture surgery.</p> Methods <p>Ninety-eight elderly patients scheduled for hip fracture surgery were enrolled and randomly assigned to two groups: the FICB + SPB group (<i>n</i> = 49, ultrasound-guided supra-inguinal FICB combined with SPB), and the SA group (<i>n</i> = 49, spinal anesthesia). The primary outcome was postoperative pain intensity assessed using visual analog scale (VAS) scores at rest and during passive movement at 3, 6, 12, 18, 24, and 48&#xa0;h postoperatively. Secondary outcomes included intraoperative hemodynamic parameters, sufentanil consumption, and rescue analgesic use. Anesthesia-related adverse events were also recorded.</p> Results <p>VAS scores at rest and during movement were significantly lower at 3, 6, 12, and 18&#xa0;h postoperatively in the FICB + SPB group (<i>P</i> &lt; 0.05). Moreover, FICB + SPB group had lower sufentanil consumption and a lower proportion of patients requiring rescue analgesia (<i>P</i> &lt; 0.05). The FICB + SPB group exhibited significantly higher blood pressure at skin incision and less intraoperative heart rate variability (<i>P</i> &lt; 0.05). The incidence of nausea, vomiting, hypotension, and constipation was significantly lower in the FICB + SPB group compared to the SA group (<i>P</i> &lt; 0.05).</p> Conclusion <p>Ultrasound-guided supra-inguinal FICB combined with SPB provides superior analgesia with fewer adverse events than spinal anesthesia, representing a safe and effective anesthetic alternative for high-risk elderly patients undergoing hip fracture surgery.</p> <p>Trial registration: The trial was retrospectively registered with the ISRCTN registry (ISRCTN16644322, registration date: 08/12/2025; <a href="https://www.isrctn.com/search?q=ISRCTN16644322">https://www.isrctn.com/search?q=ISRCTN16644322</a>).</p>

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Efficacy and safety of combined supra-inguinal fascia iliaca compartment block and sacral plexus block versus spinal anesthesia in elderly patients undergoing hip fracture surgery: a prospective randomized controlled trial

  • 期刊论文

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  • 发表日期：

    2026年4月20日

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  • Min Wang,
  • Tanglin Liu,
  • Junjin Shao,
  • Kaihua Wu

摘要

Objective

This study aimed to evaluate the efficacy and safety of ultrasound-guided supra-inguinal fascia iliaca compartment block (FICB) combined with sacral plexus block (SPB) compared with spinal anesthesia (SA) in elderly patients undergoing hip fracture surgery.

Methods

Ninety-eight elderly patients scheduled for hip fracture surgery were enrolled and randomly assigned to two groups: the FICB + SPB group (n = 49, ultrasound-guided supra-inguinal FICB combined with SPB), and the SA group (n = 49, spinal anesthesia). The primary outcome was postoperative pain intensity assessed using visual analog scale (VAS) scores at rest and during passive movement at 3, 6, 12, 18, 24, and 48 h postoperatively. Secondary outcomes included intraoperative hemodynamic parameters, sufentanil consumption, and rescue analgesic use. Anesthesia-related adverse events were also recorded.

Results

VAS scores at rest and during movement were significantly lower at 3, 6, 12, and 18 h postoperatively in the FICB + SPB group (P < 0.05). Moreover, FICB + SPB group had lower sufentanil consumption and a lower proportion of patients requiring rescue analgesia (P < 0.05). The FICB + SPB group exhibited significantly higher blood pressure at skin incision and less intraoperative heart rate variability (P < 0.05). The incidence of nausea, vomiting, hypotension, and constipation was significantly lower in the FICB + SPB group compared to the SA group (P < 0.05).

Conclusion

Ultrasound-guided supra-inguinal FICB combined with SPB provides superior analgesia with fewer adverse events than spinal anesthesia, representing a safe and effective anesthetic alternative for high-risk elderly patients undergoing hip fracture surgery.

Trial registration: The trial was retrospectively registered with the ISRCTN registry (ISRCTN16644322, registration date: 08/12/2025; https://www.isrctn.com/search?q=ISRCTN16644322).