Fascia iliaca compartment block versus no block for pain control after lower limb surgery: a meta-analysis

Figures & data

Figure 1 Anatomy of the fascia iliaca compartment block.

Figure 2 Flow diagram of the study selection process.

Abbreviations: FICB, fascia iliaca compartment block; RCTs, randomized controlled trials.

Table 1 The general characteristic of the included studies

Author and year	Country	No of patients (FICB:NB)	Gender male/female	Age (mean, FICB:NB)	BMI (mean, FICB:NB)	Technique	Complication	Nature of study	Surgery type	Standard care	FICB	Quality assessment score
Stevens et al^Citation13 2007	Australia	22/22	26/18	66.8/68.7	NS	Parallel	NS	Prospective	Total hip arthroplasty	Intravenous morphine	30 mL of 0.5% bupivacaine with 1:200,000 adrenaline, 150 μg clonidine and 9 mL of 0.9% saline (total volume 40 mL)	22, Good
Wang et al^Citation26 2011	China	32/32	NS	4.9/4.4	NS	Parallel	None	Prospective	Development dislocation of the hip	General anesthesia	Ropivacaine 0.2%, 1 mL/kg, max 30 mL	19, Fair
Wongswadiwat et al^Citation27 2012	Thailand	23/24	45/2	30/27	24/23	Perpendicular	None	Prospective	Arthroscopic anterior cruciate ligament reconstruction	Subarachnoid block	40 mL of 0.25% bupivacaine with adrenaline 1:200,000	18, Fair
Bang et al^Citation29 2016	Korea	10/11	11/10	14/7	21/23	Parallel	None	Prospective	Femur fractures	Spinal anesthesia	40 mL of ropivacaine 0.2% with epinephrine 5 μg/mL	18, Fair
Desmet et al^Citation30 2017	Belgium	43/42	52/33	60.4/66.5	27/27	Perpendicular	NS	Prospective	Total hip arthroplasty	General anesthesia	40 mL ropivacaine 0.5%	24, Good
Mouzopoulos et al^Citation31 2009	Greece	102/105	154/53	72.3/73.1	NS	Perpendicular	Hematoma (2.9%)	Prospective	Hip fracture	Epidural anesthesia	0.25 mg dose of 0.3 mL/kg bupivacaine	22, Good
Kumie et al^Citation4 2015	Ethiopia	20/20	34/6	28/29	20/19	Parallel	None	Prospective	Femur fractures	Spinal anesthesia	30 mL of 0.25% bupivacaine	23, Good

Abbreviations: BMI, body mass index; FICB, fascia iliaca compartment block; NB, no block; NS, not stated.

Figure 3 Forest plots of studies comparing FICB and NB for pain score after LLS.

Note: Weights are from random effects analysis.
Abbreviations: FICB, fascia iliaca compartment block; LLS, lower limb surgery; NB, no block; SMD, standard mean difference.

Table 2 Pooled results according to subgroup analysis

Variables	Studies (n)	Patients (n)	P-value	Incidence			Egger’s test	Begg’s test
				MD or RR (95% CI)	Heterogeneity P-value (I2)	Model
Pain score
4 h	4	217	0.041	−1.17 (−2.30 to −0.05)	0.000 (92.3)	Random	0.487	0.734
12 h	5	359	0.026	−0.41 (−0.76 to −0.05)	0.078 (52.5)	Random	0.404	0.806
24 h	6	301	0.020	−0.96 (−1.77 to −0.15)	0.000 (90.1)	Random	0.701	0.452
Morphine consumption	3	176	0.022	−2.06 (−3.82 to −0.30)	0.000 (95.3)	Random	0.093	1.000
PONV	5	261	0.008	0.44 (0.24 to 0.80)	0.538 (0)	Fixed	0.976	0.806

Abbreviations: MD, mean difference; PONV, postoperative nausea and vomiting; RR, relative risk.

Figure 4 Sensitivity analysis for the pain score after LLS.

Abbreviation: LLS, lower limb surgery.

Figure 5 Forest plots of studies comparing fascia iliaca compartment block and no block in terms of morphine consumption at 24 h after lower limb surgery.

Note: Weights are from random effects analysis.
Abbreviation: RR, relative risk.

Figure 6 Forest plots of studies comparing postoperative nausea and vomiting between the fascia iliaca compartment block and no block groups.

Abbreviation: RR, relative risk.

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