Regional anaesthesia modalities for primary total hip arthroplasty: a systematic review and component network meta-analysis
Authors' conclusion
Combined regional anaesthesia modalities, particularly PENG plus LIA, are favourable options for primary total hip arthroplasty procedures, as they result in lower pain scores, reduced opioid consumption, and motor-sparing effects in the early postoperative period.
Study context
- Population
- Patients undergoing primary total hip arthroplasty87 RCTs
- Comparison
- Single-shot regional anaesthesia modalities compared with each other
- Outcome
- Static and dynamic pain (VAS) at 6 and 12 h, and total morphine consumption at 24 h after operation
- Follow-up
- 6 and 12 h (pain); 24 h (morphine)
Methodological detailsfrequentist network meta-analysis
- Frequentist network meta-analysis
Pooled result
As reported in the abstract
Static VAS, dynamic VAS and total morphine consumption (SUCRA ranking)
- Static VAS at 6 h: femoral nerve block ranked best (SUCRA)
- 92.8%
- Static VAS at 6 h: Lumbar plexus block (LPB) plus local infiltrative analgesia (LIA) second (SUCRA)
- 85.7%
- Static VAS at 12 h: LPB plus LIA top ranked (SUCRA)
- 89.2%
- Static VAS at 12 h: quadratus lumborum block plus fascia iliaca compartment block (FICB) second (SUCRA)
- 84.8%
- Dynamic VAS at 6 h: Pericapsular nerve group (PENG) plus LIA ranked best (SUCRA)
- 86.3%
- Dynamic VAS at 12 h: LPB plus LIA ranked best (SUCRA)
- 83.4%
- Morphine consumption at 24 h: quadratus lumborum block plus FICB ranked highest (SUCRA)
- 85.5%
- Morphine consumption at 24 h: LPB plus LIA second (SUCRA)
- 82.2%
- Morphine consumption at 24 h: PENG plus LIA third (SUCRA)
- 76.5%
Safety
Motor blockade affecting quadriceps or adductor muscles
- LPB, FICB and femoral nerve block associated with increased motor blockade
- Qualitative analysis
Original publication
Regional anaesthesia modalities for primary total hip arthroplasty: a systematic review and component network meta-analysis. Br J Anaesth. Published 6 June 2025. doi:10.
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