Document Type

DNP Project

Publication Date

2021

Disciplines

Nursing

Abstract

Background and Review of Literature: Lumbar plexus block and fascia iliaca block are two commonly used anesthesia modalities for patients underdoing hip arthroplasty at Union Hospital in Terre Haute, Indiana. Currently, there are not any studies that demonstrate which block is more effective at reducing postoperative pain and opioid consumption after hip arthroplasty. Review of literature demonstrates that both blocks have their advantages and disadvantages for providing postoperative pain relief.

Purpose: To determine which block is more effective at reducing postoperative pain, opioid consumption, and length of stay in hospital after hip arthroplasty procedures. These findings will then be presented to anesthesia staff at Union Hospital.

Methods: A retrospective chart review will be conducted on 25 patients that received a lumbar plexus block and 25 that received facia iliaca block. Pain scores and opioids consumed will be calculated for each patient in each group to determine which block provides superior pain relief. Overall length of stay will be calculated for each block group as well. Microsoft Excel and SigmaXL were utilized to analyze the data. ClinCalc opioid equivalent calculator was utilized to convert all opioids administered into intravenous morphine milliequivalents

Conclusion: This project demonstrated that the fascia iliaca block was superior at reducing postoperative pain (P = 0.045) in PACU as well as reducing overall opioid consumption (P = 0.0056) when compared to the lumbar plexus block. However, length of stay in hospital and pain score at 24 hours were similar. Difficulty of block and anesthesia provider experience must also be considered.

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