Which Fascial Plane Blocks in Hip Surgery? (2022)

A discussion of the principles and evidence for 4 different fascial plane blocks currently used in hip surgery and pain - (1) fascia iliaca block, (2) PENG block, (3) quadratus lumborum (QL) block, (4) lumbar ESP block.
This is a slightly extended version of a lecture given at the 2022 RA-UK-ISURA conference in Edinburgh.

[@nerveblock]

Thanks KJC. Amazing summary of a complex topic. Totally agree that infra = another name for a femoral block. Yet to be convinced that ql and esp are worth the effort in primary arthroplasty in normal patients. Great points about confounding use of spinal and particularly IT morphine and post op analgesia. An interesting topic is the troublesome patient (opioid abuse, centrally sensitised etc) and options for them. I think their answer lies closer to the neuraxis, though comes with the expense of mobility and needs intensive catheter management to facilitate the balance between mobility and analgesia. Thanks again, the bench mark for regional teaching!

[@gc3134]

Excelent summary Dr.. K.J.Chinn, great analisys of all those RCT, and thanks for share your experiences and opinions.👍 very helpful

[@JUSSTTIINFU3K]

that was an incredible synopsis of the current state of play. Thanks!

[@btd836]

Absolutely brilliant. Thank you.

[@claustrox]

Great presentation , thank you very much!

[@nishakushwah1422]

Thank you soo.much sir
Clear so many doubts

[@titquay4494]

Thank you!

[@uramalakia]

Spinal with 100mcg morphine followed by PENG plus NFCL is a thing of analgesic beauty for total hip arthtroplasty.

[@nishakushwah1422]

Thank you soo.much sir
Clear so many doubts