CLINICAL EVALUATION OF PERIOPERATIVE ANALGESIA USING ULTRASOUND-GUIDED FASCIA ILIACA BLOCK WITH LOW-DOSE SPINAL ANAESTHESIA VERSUS CONVENTIONAL SPINAL ANESTHESIA IN GERIATRIC PATIENTS UNDERGOING HIP SURGERY: A PROSPECTIVE COMPARATIVE INTERVENTIONAL S

Abstract

Introduction: Conventional spinal anaesthesia causes hemodynamic instability in up to 33% of elderly patients. Combining ultrasound-guided Fascia Iliaca Compartment Block (FICB) with low-dose spinal anaesthesia may offer superior perioperative analgesia with enhanced cardiovascular stability. Aim: To evaluate the clinical effectiveness of perioperative analgesia using ultrasound-guided FICB combined with low dose spinal anaesthesia versus conventional low-dose spinal anaesthesia alone in geriatric patients undergoing hip surgery. Materials and Methods: This pilot prospective-comparative study was conducted at the Department of Anaesthesiology, SBKS Medical Institute and Research Centre, Sumandeep Vidyapeeth, Vadodara, Gujarat between February 2026 and March 2026. Fifty geriatric patients (≥65 years) undergoing hip surgery were allocated into two groups: Group A (n = 25) received ultrasound-guided FICB with low-dose spinal anaesthesia, and Group B (n = 25) received conventional low-dose spinal anaesthesia alone. Results: Group A demonstrated significantly greater hemodynamic stability with higher mean arterial pressure at 5 minutes (91.90 ± 6.23 vs 84.34 ± 8.55 mmHg; p = 0.001*) and 10 minutes (92.17 ± 6.10 vs 80.42 ± 7.19 mmHg; p<0.001**) post-spinal. VAS scores were significantly lower in Group A at all postoperative time points (p<0.05). Group A had significantly lower total opioid consumption (8.83 ± 3.00 vs 15.37 ± 3.86 mg morphine equivalent; p<0.001**), longer time to first rescue analgesia (342.96 ± 50.39 vs 192.45 ± 36.24 min; p<0.001**), and lower incidence of hypotension (8.0% vs 28.0%). Conclusion: Ultrasound-guided FICB combined with low-dose spinal anaesthesia provides superior perioperative analgesia, better hemodynamic stability, reduced opioid consumption, and fewer adverse events compared to low-dose spinal anaesthesia alone in geriatric hip surgery patients.