الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Different regional anaesthesia techniques have been implemented to
decrease postoperative pain following total hip arthroplasty (THA). The
fascia iliaca block (FIB) is used to block the lateral femoral cutaneous
nerve (LFCN). The LFCN is traditionally blocked below the inguinal
ligament by both regional anaesthesiologists and chronic pain specialists
or damaged below the inguinal ligament by surgeons attempting anterior
approaches in hip surgery.
Many adjuvants like epinephrine, clonidine, opioids, ketamine, and
midazolam were combined with local anaesthetics to prolong the duration
of analgesia from nerve blocks but have met with limited success.
However, the glucocorticoid dexamethasone has been shown to be
effective in a small number of preclinical and clinical studies.
Magnesium (Mg), the fourth most abundant cation in the body and
the second most abundant intracellular cation, considered as a
physiological blocker of N-methyl-D-aspartate (NMDA) receptors.
Magnesium (Mg) has anti nociceptive effects due to its antagonistic effect
of NMDA receptors.
In its inactive state, the NMDA receptor is blocked by the presence
of a centrally positioned magnesium ion, the afferent activity in
nociceptor fibers dislodges the central magnesium ion from the NMDA
receptor, therefore allowing calcium influx into the cells. The mechanism
of this technique involves injecting local anaesthetic under the iliaca
fascia where the femoral, lateral femoral cutaneous nerves, and some of
the branches of the obturator nerve lie. The fascia iliaca block is
dependent upon a sufficient spread of local anaesthetic along a connective
tissue place to penetrate under the iliaca fascia to block these nerves.