SFIB vs PENG Block in the Anesthesia for Total Hip Replacement

The block technique is based on administration of a local anesthetic under the iliac fascia to block the femoral, lateral femoral cutaneous, and obturator nerves. It is assumed that further leakage of local anesthetic through the interfascial space leads to blocking of the branches of the lumbar plexus in the small pelvis.

The hip capsule is the main source of pain because the innervation of the joint capsule is a developed network of articular branches of the femoral, sciatic and obturator nerves. The main idea of this technique is to block these branches at the point of common passage between the tendon of the lumbar muscle and the crest of the pubic bone. The block technique is based on administration of a local anesthetic under the ileo-lumbar tendon. Anesthetic spreads through the hip joint capsule and blocks small sensitive branches of the femoral and obturator nerves.

In the postoperative period, if pain occurs, the patient will be offered the opportunity to use 20 ug Fentanyl solution bolus according to the patient control analgesia (PCA) without a basic infusion.

General inhalation anesthesia will be performed in all groups, Desflurane with a minimal alveolar concentration (MAC) of 0.6-0.8 will be used for maintenance