{
  "abstract": "Background and Aims Total hip arthroplasty is a major procedure with significant postoperative pain.The aim of this study is to evaluate the effect on postoperative pain using a combination of regional blocks in total hip arthroplasty compared to standard pain management strategies.Methods In the BLAST trial (Blocks in ArthroplaSTY), 204 patients scheduled for hip arthroplasty were included. The patients were randomized to receive either standardized multimodal analgesia comprising paracetamol, celecoxib, oxycodone, and betamethasone, or standardized multimodal analgesia in conjunction with a PENG block (Pericapsular Nerve Group) and either an iliohypogastric block or an LFCN block (Lateral Femoral Cutaneous Nerve). For the posterior surgical approach, the iliohypogastric block was administered, while the lateral approach involved the LFCN block. Anesthesia was performed using either spinal anesthesia with 0.5% bupivacaine or general anesthesia with propofol and remifentanil following a TCI protocol. During the administration of the PENG, iliohypogastric, and LFCN blocks, 0.5% ropivacaine with clonidine was injected. Postoperative pain was assessed using the Numeric Rating Scale (NRS), and opioid consumption, time to mobilization, and the incidence of PONV were recorded.Results General anesthesia group without a block exhibited a mean NRS score of 5.04, whereas the block group had a mean NRS score of 3.29 upon arrival at the postoperative unit. The mean postoperative oxycodone requirement was 15.64 mg for the non-block group and 10.83 mg for the block group. Spinal anesthesia group showed NRS scores of 1.07 and 0.48 for the standard and block groups, respectively. The oxycodone requirement in the spinal anesthesia group was 4.38 mg and 4.58 mg for the standard and block groups, respectively.Conclusions When using PENG and Iliohypogastric blocks combined with general anesthesia during hip arthroplasty patients experience less postoperative pain, evaluated by NRS, and has lower opioid requirement compared to the reference group with multimodal analgesia.",
  "authors": [
    {
      "affiliations": [
        "Dep Anaesthesia and Intensive Care, Trelleborg Hospital, Trelleborg, Sweden"
      ],
      "name": "Fredrik Fellert"
    },
    {
      "affiliations": [
        "Dep Anaesthesia and Intensive Care, Trelleborg Hospital, Trelleborg, Sweden"
      ],
      "name": "Andreas Ekman"
    },
    {
      "affiliations": [
        "Dep Orthopedics, Trelleborg Hospital, Trelleborg, Sweden"
      ],
      "name": "Gunnar Flivik"
    }
  ],
  "title": "EP033 Ultrasound guided sensory nerve blocks in total hip arthroplasty",
  "uid": "372f0370-6ad7-50a4-aa16-56d0f8fe4780"
}