Comparison of Sacral Erector Spinae Plane Block and Supra-Inguinal Fascia Iliaca Block for Analgesia After Hip Fracture Surgery

Active, not recruiting

• Conditions: Hip Fracture Surgery; Postoperative Pain Management; Regional Anesthesia; Elderly Patients

• Registration Number: NCT07081867
• Lead Sponsor: Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

Brief Summary

This study compares the postoperative analgesic effectiveness of Sacral Erector Spinae Plane Block (SESPB) and Supra-Inguinal Fascia Iliaca Block (SIFIB) in patients undergoing hip fracture surgery. Both techniques are regional anesthesia methods aiming to reduce postoperative pain and opioid consumption. The study evaluates pain scores, opioid requirements, mobilization times, and hospital discharge times to determine which block provides more effective pain management in different postoperative periods.

Detailed Description

Hip fractures are common injuries among elderly patients, often resulting in high rates of morbidity and mortality. Effective postoperative pain management plays a critical role in reducing complications such as delayed mobilization, deep vein thrombosis, pneumonia, and prolonged hospitalization.

Regional anesthesia techniques, including Sacral Erector Spinae Plane Block (SESPB) and Supra-Inguinal Fascia Iliaca Block (SIFIB), have gained popularity as part of multimodal analgesia strategies that aim to minimize opioid use and improve postoperative comfort. However, there is limited evidence comparing these two techniques directly.

In this prospective observational study, patients aged 65 and older undergoing hip fracture surgery under spinal anesthesia were included. After obtaining informed consent, patients received either SESPB or SIFIB for postoperative analgesia in addition to the standard anesthetic protocol.

Pain levels were assessed using the Visual Analog Scale (VAS) at 1, 6, 12, and 24 hours after surgery. Additional data such as total opioid consumption within 24 hours, time to first analgesic requirement, mobilization time, and length of hospital stay were recorded.

The results demonstrated that patients who received SIFIB had significantly lower pain scores in the early postoperative period (1st hour), while patients who received SESPB experienced better pain relief in the late postoperative period (24th hour). No significant differences were observed between the groups in terms of total opioid consumption, mobilization time, or hospital stay duration. No complications related to the block procedures were reported.

This study suggests that both SESPB and SIFIB are safe and effective regional anesthesia techniques for postoperative pain management in hip fracture surgeries. The selection between these blocks may be based on the desired onset and duration of analgesia, with SIFIB providing superior early pain control and SESPB offering more prolonged analgesic effects.

Study Timeline

• Study Start: 2025-01-15
• Primary Completion: 2025-06-15
• Status Verified: 2025-07
• Study First Submitted: 2025-07-09
• Study First Submitted QC: 2025-07-21
• Last Update Submitted: 2025-07-21
• Study First Posted: 2025-07-23
• Last Update Posted: 2025-07-23
• Study Completion: 2025-08-01

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 77

Inclusion Criteria

• Patients aged 65 years and older
• Patients undergoing surgery for hip fractures under spinal anesthesia
• Patients who are oriented and cooperative
• Patients who have signed an informed consent form

Exclusion Criteria

• Patients with contraindications for spinal anesthesia
• Patients with Alzheimer's disease or dementia, and those who are non-oriented or non-cooperative
• Patients with major organ failure (such as heart, liver, or kidney failure)
• Patients who decline to participate in the study
• Patients classified as American Society of Anesthesiologists (ASA) Physical Status IV or higher
• Patients with pathological fractures or bone metastasis

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Postoperative Pain Scores	At 1 hour, 6 hours, 12 hours, and 24 hours postoperatively.	Pain intensity measured using the Visual Analog Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable. Pain scores will be recorded at specific postoperative time points: 1st, 6th, 12th, and 24th hours.
Time to First Postoperative Analgesic Requirement	Up to 48 hours postoperatively.	Time interval from end of surgery to the first request for analgesia.
Total Postoperative Opioid Consumption	A week	The total amount of opioids required by patients during the postoperative period.
Time to First Mobilization	From the end of surgery until first mobilization, typically within 24 to 48 hours postoperatively	The time until patients' first mobilization (walking or standing) after surgery.

Secondary Outcome Measures

Name	Time	Method
Length of Hospital Stay	Up to 14 days postoperatively.	Duration from the day of surgery to the day of hospital discharge, measured in calendar days.
Block-Related Complications	A week	Possible complications following Sacral Erector Spinae Plane Block (SESPB) and Supra-Inguinal Fascia Iliaca Block (SIFIB), such as nerve injury, infection, hematoma, etc.

Trial Locations

Locations (1)

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization; 🇹🇷 Istanbul, Sisli, Turkey