Turkish Journal of Anaesthesiology & Reanimation

Comparative Evaluation of Efficacy of Fluoroscopy and Ultrasound for Iliopsoas Block: A Randomised Trial


Department of Anaesthesiology and Pain Management, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India


Department of Anaesthesiology and Pain Management, Guru Hospital, Madurai, India


Department of Anaesthesiology and Pain Management, Narayana Hrudayalaya, Bengaluru, India

Turk J Anaesthesiol Reanim 2021; 49: 284-291
DOI: 10.5152/TJAR.2021.454
Read: 183 Downloads: 72 Published: 09 August 2021

Objective: To compare analgesic efficacy, improvement in the quality of life, psychology and learning curve for iliopsoas (IP) injection using ultrasound (US) versus fluoroscopy (FL).

Methods: Thirty-six patients with chronic low back pain secondary to IP myofascial pain were randomly allocated into two groups and were given IP injection in prone position, using either FL or US as a guide. Pain scores were assessed using numerical rating scale (NRS); learning curve was evaluated by the number of attempts, time taken and subjective ease of performing the procedure. The psychological and quality of life assessment were done using Depression Anxiety Stress Scale (DASS) and Oswestry Disability Index (ODI), respectively. 

Results: FL and US guided IP injection had equianalgesic efficacy with a decrease in preprocedure NRS pain scores from mean value of 7.06 6 0.24 and 6.78 6 0.24, respectively, to 2.22 6 0.29 and 1.78 6 0.26 (at 24 hours), 1.50 6 0.22 and 1.50 6 0.23 (1 week), 0.50 6 0.12 and 0.56 6 0.15 (4 weeks) and 0.33 6 0.11 and 0.44 6 0.15 (12 weeks) (P < .001). The learning curve was easier for US intervention with average attempts of 1–2 compared to 1–3 for FL. The average time taken to perform IP intervention was lesser for US group. The improvement in DASS and ODI was comparable in both groups.

Conclusion: FL and US both are effective modalities for IP muscle injection as they provide equal relief from pain, disability and psychological stress. US guided IP injections are easier to learn and perform in comparison with FL.

Cite this article as: Shamshery C, Vissnu Kumar V, Agarwal A, Aggarwal A, Madabushi R. Comparative Evaluation of Efficacy of Fluoroscopy and Ultrasound for Iliopsoas Block: A Randomised Trial. Turk J Anaesthesiol Reanim. 2021;49(4):284-291.

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