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

NCT ID: NCT07081867

Last Updated: 2026-01-23

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 77 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-01-15
• Study Completion Date: 2025-12-01

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.

Conditions

Hip Fracture Surgery; Postoperative Pain Management; Regional Anesthesia; Elderly Patients

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

SIFIB Group

Patients who underwent Supra-Inguinal Fascia Iliaca Block (n=40)

Supra-inguinal Fascia Iliaca Block (SIFIB)

Intervention Type: PROCEDURE

Ultrasound-guided injection of 40 mL of 0.25% bupivacaine between the iliacus muscle and fascia iliaca via a supra-inguinal approach, performed preoperatively for postoperative analgesia in patients undergoing hip fracture surgery under spinal anesthesia.

SESPB Group

Patients who underwent Sacral Erector Spinae Plane Block (n=37)

Sacral Erector Spinae Plane Block (SESPB)

Intervention Type: PROCEDURE

Ultrasound-guided injection of 40 mL of 0.25% bupivacaine into the fascial plane deep to the erector spinae muscle at the sacral level (S2), performed preoperatively for postoperative analgesia in patients undergoing hip fracture surgery under spinal anesthesia.

Interventions

Supra-inguinal Fascia Iliaca Block (SIFIB)

Ultrasound-guided injection of 40 mL of 0.25% bupivacaine between the iliacus muscle and fascia iliaca via a supra-inguinal approach, performed preoperatively for postoperative analgesia in patients undergoing hip fracture surgery under spinal anesthesia.

Intervention Type: PROCEDURE

Sacral Erector Spinae Plane Block (SESPB)

Ultrasound-guided injection of 40 mL of 0.25% bupivacaine into the fascial plane deep to the erector spinae muscle at the sacral level (S2), performed preoperatively for postoperative analgesia in patients undergoing hip fracture surgery under spinal anesthesia.

Intervention Type: PROCEDURE

Eligibility Criteria

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

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

OTHER

Sponsor Role: lead

Responsible Party

Beyzanur Aydoğdu

Resident Doctor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Beyzanur Aydogdu

Role: PRINCIPAL_INVESTIGATOR

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

Locations

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

Istanbul, Sisli, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

CT-ERHO-AR-BA-01

Identifier Type: -

Identifier Source: org_study_id