Analgesia before a spinal block for femoral neck fracture: fascia iliaca compartment block

Yun, Mi Ja; Kim, Y. H.; Han, Moon Ku; Kim, J. H.; Hwang, Jung Won; H., S.

doi:10.1111/j.1399-6576.2009.02052.x

Cited by 86 publications

(89 citation statements)

References 8 publications

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“…1,14 Also, many authors while comparing FNB with other modalities for positioning for central neuraxial block found FNB to be superior to all other modalities. 3,4,6,12,14 The drug used for the block also has a significant difference on the duration and results as shown in study conducted by Iamaroon et al, did not find much advantage of FNB over other modalities as bupivacaine was used instead of lignocaine. The effect of lignocaine in FNB comes in 5 minutes.…”

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confidence: 66%

“…4,5 Few studies have demonstrated that a fascia iliac compartment (FIC) block provides effective analgesia for a fractured femur in terms of facilitating an adequate position for spinal anaesthesia or when administered either during pre-hospital management or in emergency departments. [6][7][8] Systemic analgesics, such as narcotics, are commonly used, but their side effects profile including respiratory depression, cognitive impairment, vomiting, urinary retention, and others limits their clinical utility during injuries of the head, chest, or abdomen. [9][10][11] Previous studies suggest that the use of local anesthesia using femoral nerve block (FNB) is a safe and effective method.…”

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confidence: 99%

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Positioning for regional anesthesia in femur fracture surgeries: how effective is femoral nerve block? a randomised control study

Purohit¹,

Sireesha²,

Badami³

2017

Int J Res Med Sci

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Background: Fracture of the femur is a common orthopaedic problem following trauma in patients of all ages. This study was undertaken to evaluate the effectiveness of femoral nerve block (FNB) in positioning the patients for regional anesthesia.Methods: 100 patients between the ages 18 to 80 years, of ASA grade I, II and III, scheduled for elective surgeries of femur fracture were evaluated in 2 groups. Group FNB (n=50) received femoral nerve block with 15ml of 1.5% lignocaine and Group. Non FNB (n=50) was not given any block. Assessment of pain was carried out using visual analog scale (VAS). This was rated before, during and after the procedure of positioning for spinal/combined spinal epidural anesthesia (CSE). Vital parameters were tabulated.Results: VAS scores were noted at 0, 2, 5,10,15 minutes and at the time of positioning. VAS scores at 15 minutes after FNB was 1.473 ±0.1639 and 8.250±0.3615 in patients without FNB. Time taken for CSE was significantly less in FNB group (13.026±0.4628) minutes as compared to non FNB group (19.660 ±0.3742) minutes. Patient satisfaction scores were significantly higher in FNB group (45/50) 1.4952±0.033 as compared to non FNB group (10/50) 0.3460±0.1786. Quality of patient positioning was better in FNB group (2.782 ±0.1273) as compared to non FNB (1.382±0.2473).Conclusions:This study concludes that FNB is highly effective in giving good pain relief for positioning for regional anaesthetic procedures improving performance time and offers higher acceptance among patients with femoral fractures.

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confidence: 66%

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confidence: 99%

Positioning for regional anesthesia in femur fracture surgeries: how effective is femoral nerve block? a randomised control study

Purohit¹,

Sireesha²,

Badami³

2017

Int J Res Med Sci

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“…quadriceps) following FICB are the likely reasons for more comfortable positioning in the group. 11 This fact has been further supported by the SAB performer rated quality of positioning and acceptance of the technique by the patients.…”

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confidence: 82%

Analgesia before Performing Subarachnoid Block in the Sitting Position in Patients with Proximal Femoral Fracture: A Comparison between Fascia Iliaca Block and Femoral Nerve Block

Ghimire

Bhattarai

Koirala

et al. 2017

Kathmandu Univ. Med. J.

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Background Positioning for subarachnoid block (SAB) in patients with femoral fracture is painful and may remain suboptimal requiring use of large doses of opioids. These patients generally being elderly with multiple comorbidities and frailty are likely to have many undesirable effects of opioids including respiratory depression and confusion.Objective The objective was to compare the feasibility and effectiveness of fascia iliaca compartment block (FICB) and femoral nerve block (FNB) in reducing pain associated with positioning for subarachnoid block in patients undergoing proximal femoral fracture fixation procedures.Method Group FICB patients (n=15) received fascia iliaca block with 30 ml of 1.5% lignocaine with adrenaline and group FNB patients (n=15) received femoral nerve block with 15 ml of 1.5% lignocaine with adrenaline. After the study blocks, patients were kept on supine position for at least 20 minutes before shifting them to the operation theatre. Pain was assessed by using visual analog scale values before the block and during the position for subarachnoid block. Time to perform subarachnoid block, quality of positioning and acceptance was recorded.Result Visual analog scale values during positioning for SAB were lower in FIB group than in FNB (1.0±1.1 versus 2.1±0.8; P<0.05). Time to perform SAB was shorter in FIB than in FNB (109.6±28.2 seconds versus 134.8±31.9 seconds; P<0.05). Quality of patient positioning for SAB was comparable between the groups. Patient acceptance was less in group FNB (P<0.05).Conclusion Fascia iliaca compartment block provides better analgesia than femoral nerve block in terms of facilitating optimal positioning for subarachnoid block in patients undergoing proximal femoral fracture fixation procedure.

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“…The beneficial effect of FICB in patients with radiologically confirmed hip fractures is well known with several studies reporting a good outcome 16,17 when compared to NSAIDS 18 , alfentanil. FICB provided good pain relief for patients with femoral shaft fractures when used in prehospital care FICB is simple, easy to perform and requires less skill.…”

Section: Discussionmentioning

confidence: 89%

Duration of post-operative analgesia with Fascia iliaca compartment block (ficb) using Bupivacaine with Dexmedetomidine and Bupivacaine with Dexamethasone in patients with proximal fracture femur

Sana

Pathak

Memon

2018

ijmsci

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ABSTRACT:Introduction: Fracture of proximal femur is a common occurrence following road traffic accidents and falls (in relatively older age group). These fractures are associated with considerable pain before surgery and in postoperative period. Effective pain management during positioning and in postoperative period is crucial and fascia Iliaca compartment block can be used effectively for this purpose in these patients. Many adjuvants like epinephrine, clonidine, Opioids, ketamine, dexamethasone and dexmedetomidine were combined with local anaesthetics to prolong the post-operative analgesia. We conducted this prospective study to know duration of post-operative analgesia with Fascia iliaca compartment block (ficb) using Bupivacaine with Dexmedetomidine and Bupivacaine with Dexamethasone in patients with proximal fracture femur. Materials and methods: This was a randomized, prospective, double blinded and controlled study done in the department of anesthesiology of a medical college situated in an urban area. 90 patients of either gender , ASA grade I & II ,the age of whom was between 18-80 years and who were undergoing surgery for proximal fracture femur under spinal anesthesia were enrolled in this study . All these patients received FICB by landmark technique before spinal anesthesia. The patients were divided in 3 groups. Group I -Patient in this group received 0.25% Bupivacaine plus normal saline 0.9%. Group II Patient in this group received 0.25% Bupivacaine plus dexamethasone. Group III Patient in this group received 0.25% Bupivacaine plus dexmedetomidine. Level of analgesia during positioning and in post operative period along with other parameters like sedation scores, VAS scores, hemodynamics and complications in these 3 groups were compared. Results: The study comprised of 90 patients out of which 45 (50%) were males and 45 (50%) were females with a M: F ratio of 1:1. ASA Grades and Mean duration of surgeries in these groups were comparable. For preoperative Pulse Rate, SBP, SpO2 the test used was One-Way ANOVA. p > 0.05 for all three parameters. There was no significant difference in onset of FICB and time required for giving spinal anesthesia in three groups (p>0.05). 27(90%) patients in group I, 25(83%) patients in group II and 26(87%) patients in group III had no sensation to pinprick thirty minutes after FICB. Preoperative pulse rate and pulse rate thirty minutes after FICB were compared .There was significant reduction in pulse rate (p<0.05) in group III 30 minutes after FICB. The analysis of changes in mean pulse rates showed that there was no significant difference in mean pulse rate intraoperatively (p>0.05). the study of postoperative duration of analgesia showed that There was highly significant difference in post-operative duration of analgesia between group I&II ,group I&III and group II&III . Conclusion: Addition of dexamethasone or dexmedetomidine to Bupivacaine for fascia iliaca compartment block in patients with proximal femur fracture further prolongs post-operative analgesia comp...

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Analgesia before a spinal block for femoral neck fracture: fascia iliaca compartment block

Abstract: An FIC block is more efficacious than i.v. alfentanil in terms of facilitating the lateral position for spinal anaesthesia in elderly patients undergoing surgery for femoral neck fractures.

Cited by 86 publications

References 8 publications

Positioning for regional anesthesia in femur fracture surgeries: how effective is femoral nerve block? a randomised control study

Positioning for regional anesthesia in femur fracture surgeries: how effective is femoral nerve block? a randomised control study

Analgesia before Performing Subarachnoid Block in the Sitting Position in Patients with Proximal Femoral Fracture: A Comparison between Fascia Iliaca Block and Femoral Nerve Block

Duration of post-operative analgesia with Fascia iliaca compartment block (ficb) using Bupivacaine with Dexmedetomidine and Bupivacaine with Dexamethasone in patients with proximal fracture femur

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