The Fascia Iliaca Compartment Block: Review Article

Abstract

Fascia Iliaca Compartment Block (FICB) has become an essential component of multimodal analgesia for patients suffering from acute pain related to hip fractures, femoral trauma, and lower-limb surgeries. Pain originating from these conditions is often severe and may be difficult to control using systemic analgesics alone, especially in vulnerable populations such as elderly patients. Opioid-based regimens, although effective, are associated with adverse effects including respiratory depression, sedation, gastrointestinal dysfunction, and an increased risk of postoperative delirium. These limitations have driven the expanding use of regional anesthesia techniques that provide effective pain relief while minimizing systemic drug exposure. The anatomical basis of FICB allows for broad sensory blockade by targeting the femoral nerve, lateral femoral cutaneous nerve, and to a lesser extent the obturator nerve through the deposition of local anesthetic beneath the fascia iliaca. This results in substantial analgesia of the anterior and lateral thigh as well as the hip joint. With the introduction of ultrasound guidance, the accuracy and reliability of FICB have improved significantly, enhancing onset time, block success rate, and overall patient satisfaction. As enhanced recovery pathways continue to emphasize early mobilization and opioid-sparing strategies, FICB is increasingly recognized as a valuable tool in perioperative pain management.