Comparative study of efficacy of femoral nerve block and IV fentanyl for positioning during femur fracture surgery

Reddy, E. Devendar; Rao, B. Dinakar

doi:10.18203/2349-2902.isj20160252

Cited by 6 publications

(25 citation statements)

References 16 publications

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“…Full-text articles were excluded with no comparison (n = 4), no comparison of interest (n = 6), different interventions (n = 9), no relevant outcome measure (n = 12), and review articles (n = 4). Ten studies [10][11][12][13][14][15][16][17][18][19] were ultimately included for qualitative and quantitative synthesis. single centers in Italy [16], Ireland [18], Pakistan [10], India [12,13,15,17,19], Nepal [14], and Thailand [11].…”

Section: Discussionmentioning

confidence: 99%

“…Two [10,12] of the studies recruited a majority of females for FNB. Four [11,15,17,19] studies recruited equal numbers of the two sexes, and one [13] study provided no information on sex. Three trials [10,11,16] reported the time from trauma to surgery, and averages ranged from 2.3-15.6 days.…”

Section: Discussionmentioning

confidence: 99%

“…For the method of FNB, time from the intervention to SA varied from 5 to 30 min. Most studies used the landmark method [10][11][12][13][15][16][17][18][19] or a stimulator [11][12][13][14][15][16][17][18][19] to perform FNB. The doses and types of local anesthetics were different.…”

Section: Discussionmentioning

confidence: 99%

“…Increasing numbers of published studies compared FNB to IVA with femur fractures for positioning for SA [10][11][12][13][14][15][16][17][18][19]. But this evidence is not well-integrated.…”

Section: Introductionmentioning

confidence: 99%

“…Tables 1 and S2 show the characteristics of the included studies. Eight studies [10][11][12][14][15][16][17][18] were RCTs, and two studies [13,19] observational studies. These studies were performed in Positioning of femur fracture patients for spinal block PLOS ONE | https://doi.…”

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confidence: 99%

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Efficacy and safety of femoral nerve block for the positioning of femur fracture patients before a spinal block – A systematic review and meta-analysis

Hsu

Chu

et al. 2019

PLoS ONE

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Background The evidence supporting the benefit of femoral nerve block (FNB) for positioning before spinal anesthesia (SA) in patients suffering from a femur fracture remains inconclusive. In the present study, the authors intended to determine the efficacy and safety of FNB versus an intravenous analgesic (IVA) for positioning before SA in patients with a femur fracture. Method PubMed, EMBASE, Cochrane, and Scopus databases were searched up to January 2018. We included randomized controlled studies (RCTs) and observational studies that compared FNB versus IVA for the positioning of patients with femur fracture receiving SA. The primary outcome was pain scores during positioning within 30 min before SA. Secondary outcomes were the time for SA, additional analgesic requirements, anesthesiologist’s satisfaction with the quality of positioning for SA, participant acceptance, and hemodynamic changes. A random-effects model was used to synthesize the data. We registered the study at PROSPERO with an ID of CRD42018091450. Results Ten studies with 584 patients were eligible for inclusion. FNB achieved significantly lower pain scores than IVA during positioning within 30 min before SA (pooled standardized mean deviation (SMD): -1.27, 95% confidence interval (CI): -1.84 to -0.70, p < 0.05). A subgroup analysis showed that the analgesic effect was larger in patients in the sitting position for SA than a non-sitting position (sitting position vs non-sitting: pooled SMD: -1.75 ( p < 0.05) vs -0.61 (not significant). A multivariate regression showed that the analgesic effect was also associated with age and the total equivalent amount as lidocaine after adjusting for gender (age: coefficient 0.048, p < 0.05; total equivalent amount as lidocaine: coefficient 0.005, p < 0.05). Patients receiving FNB also had a significantly shorter time for SA, greater anesthesiologist satisfaction, and higher patient acceptance than patients receiving IVA. The use of local anesthetics did not produce significant clinical hemodynamic change. Conclusion Compared to IVA, FNB was an effective and safe strategy for the positioning of femur fracture patients for a spinal block, particularly patients who received SA in the sitting position.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Increasing numbers of published studies compared FNB to IVA with femur fractures for positioning for SA [10][11][12][13][14][15][16][17][18][19]. But this evidence is not well-integrated.…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy and safety of femoral nerve block for the positioning of femur fracture patients before a spinal block – A systematic review and meta-analysis

Hsu

Chu

et al. 2019

PLoS ONE

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Peripheral nerve blocks for hip fractures in adults

Guay

Kopp

2020

Cochrane Database of Systematic Reviews

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Ultrasound‐guided femoral nerve block and intravenous fentanyl in pain management of the patients with hip fracture: a prospective, randomized, single blinded clinical trial

Mayel

Foroughian

Zamani

et al. 2022

Acute Medicine & Surgery

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Aim Proximal femoral fracture is a painful condition. Pain alleviation is a treatment cornerstone to both comfort the patient and reduce adverse effects. This study aimed to evaluate and compare ultrasound‐guided femoral nerve block and intravenous fentanyl administration in relieving the pain of patients with hip fractures. Methods The present interventional clinical trial was conducted on 40 patients referred to Shahid‐Bahonar Hospital with unilateral isolated proximal femur fracture and American Society of Anesthesiologists I and II. The patients were randomly divided into two groups: intravenous fentanyl and ultrasound‐guided femoral nerve block for pain management. Pain severity was assessed by a numerical rating scale before and after the intervention in both groups and the groups were then compared. Results Forty patients were enrolled in to study; 27 (67.5%) were male. There was no significant difference in demographic variables between the two groups. Fourteen (35%) were older than 80 years. Pain significantly decreased three scores compared to the pre‐intervention level in both groups (95% confidence interval, 2–4). This was slightly higher in the femoral nerve block group. The largest strength of association for age and numerical rating scale of pain was found in the differences between the pre‐intervention and after‐intervention in femoral nerve block group ( r = −0.775, P < 0.001). Conclusion We found similar pain severity between the two groups. Considering the possible side effects of fentanyl, an ultrasound‐guided femoral nerve block shows may provide safer pain control and may be particularly suitable for patients with opioid dependence.

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Comparative study of efficacy of femoral nerve block and IV fentanyl for positioning during femur fracture surgery

Cited by 6 publications

References 16 publications

Efficacy and safety of femoral nerve block for the positioning of femur fracture patients before a spinal block – A systematic review and meta-analysis

Efficacy and safety of femoral nerve block for the positioning of femur fracture patients before a spinal block – A systematic review and meta-analysis

Peripheral nerve blocks for hip fractures in adults

Ultrasound‐guided femoral nerve block and intravenous fentanyl in pain management of the patients with hip fracture: a prospective, randomized, single blinded clinical trial

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