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

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Vol 6 | Issue 2 | July-December 2025 | Page 08-11 | Kirtika Yadav, Neel Kamal Mishra, Prem Raj Singh

DOI: https://doi.org/10.13107/ijra.2025.v06.i02.132

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

References

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How to Cite this Article: Yadav K, Mishra NK, Singh PR. Para-Iliopsoas Block: Anatomical Rationale, Technique, and Contemporary Clinical Perspective. International Journal of Regional Anaesthesia. July-December 2025; 6(1): 08-11. DOI: https://doi.org/10.13107/ijra.2025.v06.i02.132

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Thoracic Wall Blocks for Thoracic Surgery

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Vol 4 | Issue 2 | July-December 2023 | Page 01-08 | Neha Pangasa, Anjolie Chhabra

DOI: https://doi.org/10.13107/ijra.2023.v04i02.075

Submitted: 08-07-2023; Reviewed: 01-09-2023; Accepted: 09-10-2023; Published: 10-12-2023

Authors: Neha Pangasa [1], Anjolie Chhabra [1]

[1] Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

Address of Correspondence
Dr. Neha Pangasa
Assistant Professor, Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Email- nehapangasa@gmail.com

Abstract

Thoracic epidural, paravertebral block and intercostal nerve block were the conventional methods of providing analgesia for thoracic surgery, about a decade ago. In the modern era with the advent of ultrasound guided regional anesthesia, the fascial plane blocks came as a boon to anesthesiologists. These blocks are safer, as the needle tip remains distant from the pleura and they are technically easier to perform. We have described in brief the various techniques for thoracic wall analgesia with special emphasis to fascial plane blocks, along with the current evidence for each block.
Keywords: Thoracic wall blocks, Fascial plane blocks, Local anaesthetic

References

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How to Cite this Article: Pangasa N, Chhabra A | Thoracic Wall Blocks for Thoracic Surgery | International Journal of Regional Anaesthesia | July-December 2023; 4(2): 01-08 | DOI: https://doi.org/10.13107/ijra.2023.v04i02.075

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