Ultrasound-guided iliopsoas plane block, the effects on postoperative pain, opioid consumption, and quadriceps strength in adults undergoing hip surgery: A Systematic Review

Abstract

The iliopsoas plane block (IPB) is a novel motor-sparing analgesic technique for hip surgery. While promising, its clinical benefits over conventional nerve blocks remain uncertain due to limited evidence. This systematic literature review evaluates postoperative pain, quadriceps strength, and quality of recovery after ultrasound-guided iliopsoas plane block (IPB) compared with conventional analgesic nerve blocks in hip surgery. It is hypothesized that IPB reduces postoperative pain and opioid consumption, without a decline in quadriceps strength. Following PRISMA guidelines, we systematically reviewed studies on IPB in patients undergoing hip surgery under general anesthesia. Databases were searched up to May 2025. Seven RCTs and two case series were included, assessing postoperative pain, opioid use, and quadriceps strength. One RCT reported significantly lower pain scores with IPB compared with sham, while other studies found no significant differences compared with sham or other blocks. Two RCTs showed reduced opioid consumption with IPB, while others showed no difference. Postoperative opioid consumption after IPB was significantly less in two out of four studies after surgery (p < 0.001). Regarding postoperative quadriceps strength, one study showed superior strength in the IPB group compared with the femoral nerve block (FNB) group at various time points (p < 0.05), whereas other studies found no significant differences or reductions in strength compared with sham (p > 0.05). Seven RCTs showed mixed results in postoperative outcomes. Our findings show that multiple studies reveal that IPB may influence postoperative pain and opioid use while highlighting its potential to preserve quadriceps strength. INTRODUCTION This pain can impede their ability to move, prolonging their hospital stay, and negatively impacting their 8 Hip arthroplasty is one of the most frequently performed postoperative functionality . In addition, uncontrolled 1 and successful surgical int