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BACKGROUND: In this study we compared the effect of postoperative analgesia after total hip arthroplasty with continuous femoral nerve (FEM) or fascia iliaca compartment blocks (FIC) on the functional outcome one year after the operation.
METHODS: Primary we included 88 patients who were scheduled for total hip replacement and divided them randomly into the FEM (40 patients) and the FIC (40 patients) group. There was also a small control group of 8 patients who did not receive a continuous nerve block, but a conservative intravenous patient-controlled analgesia. For the one year follow up there were 32 patients in the FEM group, 30 patients in the FIC group and 7 patients left in the control group. For the judgement of the functional outcome of the patients a hip examination was done in which the range of motion was measured using the neutral-0-method and tested for signs of nerval lesions or paraesthesia. In addition we used the harris hip score, the lequesne index, the WOMAC index, the hip outcome score and the sf-36, as well as standardised questions about the satisfaction and the comfort. We compared our results to the preoperative findings.
RESULTS: There were no significant differences in functional outcome between the groups. The only significant finding was the lower score of the FEM group in the sf-36 questionnaire in the comparison of the pre-and postoperative results (FEM vs. FIC: p=0,0001; all groups in comparison: p=0,001). Another finding was that there were 6 patients in FEM group and 5 in the FIC group with paraesthesia in the lower extremity on the operated side but none in the control group.
CONCLUSIONS: This study suggests that there are no significant differences in the functional outcome between the intervention groups FEM and FIC. There were no severe side effects recorded. The control group is too small to draw conclusions.