Clinical applications and advances of iliopsoas plane block in hip surgery

BACKGROUND: Iliopsoas plane block (IPB), as an emerging regional anesthesia technique, shows promising applications in analgesia for hip surgery. This review aims to elucidate the anatomical basis and mechanism of action of IPB, systematically assess its clinical efficacy, procedural techniques, and recent research progress in hip surgery, analyze its advantages and disadvantages compared to traditional regional blocking techniques, and explore its role in multimodal analgesic regimens and future development directions. METHODS: The authors systematically searched the PubMed and Web of Science databases for all published literature related to IPB from its inception until September 2025. RESULTS: Recent studies indicate that IPB, by injecting local anesthetics in the iliopsoas plane, can selectively block the sensory branches of the femoral nerve supplying the hip joint capsule, providing effective analgesia while significantly preserving motor function. Compared to traditional femoral nerve block, IPB reduces the incidence of quadriceps weakness and lowers the risk of falls in patients, particularly in elderly individuals undergoing hip surgery. The application of ultrasound guidance further enhances the accuracy and safety of IPB. However, high-quality clinical evidence supporting IPB is still limited, and its clinical effectiveness remains controversial. Further exploration of its mechanisms of action, optimal techniques, and ideal injection doses is needed, along with more basic research and clinical trials. CONCLUSIONS: IPB is a safe and effective postoperative analgesic technique for hip surgery. The motor function preservation characteristics of IPB align with enhanced recovery after surgery principles, making it a promising candidate to become the preferred analgesic technique for perioperative pain management in hip surgery. Future research requires more standardized, homogeneous controlled studies and exploration of its potential in chronic pain management.