REVIEW article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1611618
This article is part of the Research TopicInsight in Geriatric Pain – 2023View all 4 articles
Ultrasound-Guided Fascia Iliaca Compartment Block Versus Intravenous Analgesia in Geriatric Hip Fractures: A Systematic Review and Meta-Analysis of Randomized Trials Demonstrating Superior Pain Control
Provisionally accepted
- 1Southwest Medical University, Luzhou, Sichuan, China
- 2Wenjiang District People's Hospital, Chengdu, Sichuan Province, China
- 3Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
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Background: Severe pain in elderly hip fracture patients exacerbates perioperative risks. This meta-analysis compares ultrasound-guided fascia iliaca compartment block 2 (UG-FICB) with intravenous analgesia for pain management.A comprehensive search of randomized controlled trials (RCTs) published through February 2025 was conducted across major databases, including Englishlanguage databases and Chinese databases. Outcomes analyzed via RevMan 5.3 using random/fixed-effect models. Primary outcomes encompassed Visual Analog Scale (VAS) scores, analgesic consumption, patient satisfaction, main adverse reactions, and gastrointestinal adverse events. Secondary outcomes included intraoperative blood loss, operative time, length of stay, and respiratory adverse events.Results: A total 26 RCTs (n=2,347), UG-FICB significantly not only reduced Visual Analog Scale (VAS) scores at all timepoints: 0.5 h (P=0.02), 2 h (P=0.001), 4 h (P=0.002), 6 h (P<0.00001), 12 h (P=0.0002), 24 h (P<0.00001), and 48 h postoperatively (P=0.003), but also reduced postoperative analgesic consumption (OR=5.27, P<0.00001). Patients receiving UG-FICB exhibited fewer drug-related adverse events, including dizziness (OR=2.34), hypersomnia (OR=3.58), and gastrointestinal complications (nausea OR=2.57; constipation OR=4.82; P<0.05). UG-FICB also shortened length of stay (MD=1.88 days, P<0.00001) and enhanced satisfaction (OR=0.26, P=0.0002).Compared to intravenous analgesia, UG-FICB provides superior, sustained pain relief with fewer opioid-related complications and higher patient satisfaction. UG-FICB's safety and efficacy advantages strongly support its adoption as first-line therapy in geriatric hip fractures protocols.
Keywords: Meta-analysis, rct, FICB, Intravenous analgesia, Hip Fractures
Received: 17 Apr 2025; Accepted: 24 Jul 2025.
Copyright: © 2025 Liu, Han, Wei, Yang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mengchang Yang, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
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