Efficacy of Peripheral Nerve Blocks in Posterior Approach Total Hip Arthroplasty: A Systematic Review

This systematic review investigates whether one nerve block is more effective than the others for posterior approach total hip arthroplasty (THA) patients. PubMed, Embase, and Web of Science were searched for studies published prior to June 6, 2022, investigating the fascia iliaca (FIB), lumbar plexus (LPB), or pericapsular nerve group (PENG) blocks in THA and the effects on postoperative pain scores, opioid usage, and/or length of stay (LOS). The initial 226 articles were narrowed to 10 studies encompassing 595 patients. The FIB group had lower pain scores than the no-block group at 12 hours. The LPB group had lower pain scores than the no-block group at 12 hours, lower opioid consumption at 24 hours and shorter LOS. The PENG group had lower opioid consumption at 48 hours than the no-block group and shorter LOS than the LPB group. Each block type was found to have benefits for improving pain scores, opioid use, or LOS. (Journal of Surgical Orthopaedic Advances 35(3):122–128, 2026)

Key words: total hip arthroplasty, posterior approach, fascia iliaca block, lumbar plexus block, pericapsular nerve
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