The efficiency and safety of fascia iliaca block for pain control after total joint arthroplasty

BACKGROUND This meta-analysis aimed to perform a meta-analysis including randomized controlled trials (RCTs) to assess the efficiency and safety of fascia iliaca block (FIB) for pain control in patients undergoing total joint arthroplasty (TJA). METHODS A systematic search was performed in Medline (1966-2017.03), PubMed (1966-2017.03), Embase (1980-2017.03), ScienceDirect (1985-2017.03) and the Cochrane Library. Study evaluated the efficiency and safety of FIB in TJA was selected. Meta-analysis was performed using Stata 11.0 software. RESULTS Five randomized controlled trials (RCTs) including 270 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of visual analog scale (VAS) score at 12 hours (SMD = -0.544, 95% CI: -0.806 to -0.281, P = .000) and 24 hours (SMD = -0.519, 95% CI: -0.764 to -0.273, P = .000), morphine equivalent consumption at 12 hours (SMD = -0.895, 95% CI: -1.164 to -0.626, P = .000) and 24 hours (SMD = -0.548, 95% CI:-0.793 to -0.303, P = .000). In addition, fewer adverse side effect was identified in FIB groups (RD = -0.139, 95% CI: -0.243 to -0.034, P = .009). CONCLUSION The application of fascia iliaca block could significantly reduce VAS scores and morphine consumption at 12 and 24 hours following total knee and hip arthroplasty. In addition, there were fewer adverse effects in FIB groups. Due to the limited quality of the evidence currently available, higher quality RCTs are required.