Effects of liposomal bupivacaine versus ropivacaine for fascia iliaca compartment block on postoperative pain and delirium in elderly patients undergoing hip arthroplasty.

OBJECTIVE: To compare the effects of fascia iliaca compartment block (FICB) with liposomal bupivacaine versus ropivacaine on postoperative pain and delirium in elderly patients undergoing total hip arthroplasty (THA). METHODS: Eighty-six elderly patients who underwent THA were retrospectively enrolled. They were divided into a liposomal bupivacaine group (LB group, n=43) and a ropivacaine group (R group, n=43) based on the medication administered. Perioperative hemodynamic parameters, inflammatory markers, postoperative pain intensity, incidence of delirium, analgesic use, postoperative recovery outcomes, and complication rates were compared between the groups. RESULTS: The LB group had significantly lower Numerical Rating Scale scores than the R group both at rest and on movement at 12, 24, 48, and 72 hours postoperatively (P<0.05). The LB group had significantly lower inflammatory marker levels than the R group at 24 and 48 hours postoperatively. The LB group had a significantly lower incidence of postoperative delirium (POD) than the R group (4.65% vs. 18.60%, P<0.05). The LB group had fewer patient-controlled intravenous analgesia (PCIA) attempts, longer time to first PCIA, and lower sufentanil consumption postoperatively (P<0.05). The LB group had significantly shorter time to first ambulation and length of hospital stay compared with the LB group (P<0.05). CONCLUSION: FICB with liposomal bupivacaine may be associated with prolonged analgesia, a lower incidence of POD, faster recovery, and fewer complications in elderly patients undergoing THA.