Para-Iliopsoas Block: Anatomical Rationale, Technique, and Contemporary Clinical Perspective

Vol 6 | Issue 2 | July-December 2025 | Page 00-00 | Kirtika Yadav, Neel Kamal Mishra, Prem Raj Singh

DOI: https://doi.org/10.13107/ijra.2025.v06.i02.000

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 11-08-2025; Reviewed: 09-09-2025; Accepted: 21-11-2025; Published: 10-12-2025

Authors: Kirtika Yadav [1], Neel Kamal Mishra [1], Prem Raj Singh [1]

[1] Department of Anaesthesiology, King George’s Medical University, Lucknow, U.P., India.

Address of Correspondence

Dr. Prem Raj Singh,
Department of Anaesthesiology, King George’s Medical University, Lucknow, U.P. India.
E-mail: dr.p.rajsingh@gmail.com

Abstract

The para-iliopsoas (PIP) plane block is a novel regional anaesthesia technique developed to enhance analgesia for hip and proximal thigh surgeries. By targeting the fascial plane between the iliopsoas complex and fascia iliaca at the level of the anterior superior iliac spine, the PIP block facilitates deposition of local anaesthetic near the lumbosacral trunk. This approach aims to achieve reliable blockade of the femoral nerve, lateral femoral cutaneous nerve, and potentially the obturator nerve, thereby improving hip joint analgesia while minimizing quadriceps weakness. Ultrasound guidance enables precise needle placement and visualization of spread, with volumes of 20–30 ml required to overcome fascial resistance and promote longitudinal distribution. Clinical applications include total hip arthroplasty, hip arthroscopy, femoral neck fractures, and anterior thigh procedures, with reported benefits of reduced opioid consumption and improved patient positioning for neuraxial anaesthesia. However, limitations include variable obturator coverage, anatomical variability, and risks of peritoneal or vascular injury with deep needle advancement. Current evidence is limited to cadaveric, imaging, and small clinical series, underscoring the need for further validation. The PIP block holds promise as part of multimodal, opioid-sparing analgesia strategies in hip surgery.
Keywords: Regional anaesthesia, Fascial plane blocks, Hip surgery

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