Regional anesthesia for hip surgery: A review of current approaches and their application to clinical practice

Hip surgery is extremely common and ranges from surgery for hip fracture to elective procedures in younger adults. Pain can mark the postoperative period and compromise functional recovery. Nevertheless, major comorbidities may occur in the perioperative period, especially in elderly fragile patient...

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Main Authors: Tiberio Evangelista, Camilla Pugno, Simone Finazzi, Alessandro Colombi, Dario Bugada
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Saudi Journal of Anaesthesia
Subjects:
Online Access:https://journals.lww.com/10.4103/sja.sja_68_25
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author Tiberio Evangelista
Camilla Pugno
Simone Finazzi
Alessandro Colombi
Dario Bugada
author_facet Tiberio Evangelista
Camilla Pugno
Simone Finazzi
Alessandro Colombi
Dario Bugada
author_sort Tiberio Evangelista
collection DOAJ
description Hip surgery is extremely common and ranges from surgery for hip fracture to elective procedures in younger adults. Pain can mark the postoperative period and compromise functional recovery. Nevertheless, major comorbidities may occur in the perioperative period, especially in elderly fragile patients. The approach to patients undergoing hip surgery has significantly evolved, focusing on multimodal strategies to optimize pain control while minimizing side effects, prompting patients’ recovery. The seek for motor-sparing, analgesic techniques with a better risk benefit profile has promoted the application of new peripheral nerve blocks, with special attention paid to the newest fascial plane blocks. However, significant interest is addressed toward other outcomes (such major comorbidities and deaths) that may influence intermediate and long-term recovery. Specific strategies have been investigated to improve outcomes after hip surgery in elderly patients, considering the higher risk for complications, including delirium. In this narrative review, we aim to summarize the role of regional anesthesia and analgesia in the context of hip surgery by detailing on the effects of regional anesthesia on major outcomes. Considering the specific innervation of hip joint, we summarize the available evidence on newer peripheral nerve blocks for hip patients by focusing on potential complications associated with each technique, especially the occurrence of motor block. In this review, we aim to provide an updated and concise overview of the available evidence to help the reader planning the most appropriate strategy for hip surgery.
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series Saudi Journal of Anaesthesia
spelling doaj-art-44b98c99e27b49078a14cc712fce32382025-08-20T03:04:45ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X0975-31252025-04-0119216417310.4103/sja.sja_68_25Regional anesthesia for hip surgery: A review of current approaches and their application to clinical practiceTiberio EvangelistaCamilla PugnoSimone FinazziAlessandro ColombiDario BugadaHip surgery is extremely common and ranges from surgery for hip fracture to elective procedures in younger adults. Pain can mark the postoperative period and compromise functional recovery. Nevertheless, major comorbidities may occur in the perioperative period, especially in elderly fragile patients. The approach to patients undergoing hip surgery has significantly evolved, focusing on multimodal strategies to optimize pain control while minimizing side effects, prompting patients’ recovery. The seek for motor-sparing, analgesic techniques with a better risk benefit profile has promoted the application of new peripheral nerve blocks, with special attention paid to the newest fascial plane blocks. However, significant interest is addressed toward other outcomes (such major comorbidities and deaths) that may influence intermediate and long-term recovery. Specific strategies have been investigated to improve outcomes after hip surgery in elderly patients, considering the higher risk for complications, including delirium. In this narrative review, we aim to summarize the role of regional anesthesia and analgesia in the context of hip surgery by detailing on the effects of regional anesthesia on major outcomes. Considering the specific innervation of hip joint, we summarize the available evidence on newer peripheral nerve blocks for hip patients by focusing on potential complications associated with each technique, especially the occurrence of motor block. In this review, we aim to provide an updated and concise overview of the available evidence to help the reader planning the most appropriate strategy for hip surgery.https://journals.lww.com/10.4103/sja.sja_68_25analgesiacomplicationsenhanced recoveryhip surgerymotor blockpostoperative painregional anesthesia
spellingShingle Tiberio Evangelista
Camilla Pugno
Simone Finazzi
Alessandro Colombi
Dario Bugada
Regional anesthesia for hip surgery: A review of current approaches and their application to clinical practice
Saudi Journal of Anaesthesia
analgesia
complications
enhanced recovery
hip surgery
motor block
postoperative pain
regional anesthesia
title Regional anesthesia for hip surgery: A review of current approaches and their application to clinical practice
title_full Regional anesthesia for hip surgery: A review of current approaches and their application to clinical practice
title_fullStr Regional anesthesia for hip surgery: A review of current approaches and their application to clinical practice
title_full_unstemmed Regional anesthesia for hip surgery: A review of current approaches and their application to clinical practice
title_short Regional anesthesia for hip surgery: A review of current approaches and their application to clinical practice
title_sort regional anesthesia for hip surgery a review of current approaches and their application to clinical practice
topic analgesia
complications
enhanced recovery
hip surgery
motor block
postoperative pain
regional anesthesia
url https://journals.lww.com/10.4103/sja.sja_68_25
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AT camillapugno regionalanesthesiaforhipsurgeryareviewofcurrentapproachesandtheirapplicationtoclinicalpractice
AT simonefinazzi regionalanesthesiaforhipsurgeryareviewofcurrentapproachesandtheirapplicationtoclinicalpractice
AT alessandrocolombi regionalanesthesiaforhipsurgeryareviewofcurrentapproachesandtheirapplicationtoclinicalpractice
AT dariobugada regionalanesthesiaforhipsurgeryareviewofcurrentapproachesandtheirapplicationtoclinicalpractice