Total hip arthroplasty (THA) is one of the most common surgical procedures performed in
elderly patients, with its main indication being end-stage osteoarthritis of the hip1. It is
estimated that over 572,000 patients per year will undergo THA in the USA alone by 20301 and
postsurgical pain associated with THA remains a significant issue. Postoperative pain is
associated with delayed joint mobilization, ambulation, patient satisfaction and can often
delay the patient's discharge home1.
Multimodal analgesia for the management of postoperative pain following THA is now standard
of care2,3. It involves a combination of local anesthetic infiltration (LAI), peripheral
nerve blocks (PNBs), analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs),
acetaminophen and/or other medications, including gabapentinoids and opioids. Using multiple
analgesic modalities allows for an easier and faster recovery for THA patients and ultimately
allows for reduction in postoperative narcotic use and it's associated negative side effects.
Total hip arthroplasty can be performed under either general anesthesia, epidural anesthesia
or most commonly under spinal anesthesia, with or without epidural morphine. The adjunctive
use of LAI, pericapsular nerve group (PENG) block or suprainguinal fascia iliaca compartment
block (FICB) for postoperative pain management is becoming more widespread, although evidence
on their efficacy has been inconsistent4-8. As such, comparative evaluation of these
adjuctive analgesic modalities is imperative to optimize postoperative pain management
following THA.