Fascia iliaca compartment block: its efficacy in pain control for patients with proximal femoral fracture

Fujihara, Yuki; Fukunishi, Shigeo; Nishio, Shoji; Miura, Jyuichi; Koyanagi, Sahoko; Yoshiya, Shinichi

doi:10.1007/s00776-013-0417-y

Cited by 45 publications

(49 citation statements)

References 12 publications

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“…Monzón et al 16 found the FICB offered better pain relief than intravenous (IV) NSAIDs at 15 minutes (p < 0.001), but the opposite was true after eight hours. Fujihara et al 15 found improved pain with the FICB at all times compared to rectally administered NSAIDs, but this study was at particularly high risk of bias.…”

Section: Resultsmentioning

confidence: 68%

“…Of the included studies, two utilized the traditional FNB, 8,9 four used the 3-in-1 FNB, [10][11][12][13] and three used the FICB [14][15][16] . Baseline demographics were similar between studies, with a weighted mean age of 80.6, 79.5, and 76.4 years in the FNB, 3-in-1 FNB, and FICB studies respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The risk of bias came largely from a lack of double blinding in six out of nine studies; 8,9,[11][12][13]15 however, the studies by Beaudoin et al, 10 Foss et al, 14 and Monzón et al 16 attempted to blind patients and clinicians by performing sham nerve blocks. Five studies also suffered from inadequate blinding of outcome assessment, 9,[12][13][14][15] and four studies included patients who were later unaccounted for in the final results. 8,11,12,16 All of the included randomized controlled trials were small, ranging in size from 33 patients to 154 patients (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The FICB studies all used different local anesthetics, which made direct comparison of these studies difficult. Only one study 10 used ultrasound guidance, whereas the remainder used either landmark technique 8,11,[14][15][16] or nerve stimulator guidance 9,12,13 . An emergency physician or resident performed the nerve block in five out of nine studies [9][10][11][12]16 .…”

Section: Resultsmentioning

confidence: 99%

“…For the primary outcome of visual analog score pain reduction with a regional nerve block, eight out of nine studies [8][9][10][11][13][14][15][16] concluded there was an equal or superior benefit with a nerve block compared to standard pain management (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

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Regional Nerve Blocks For Hip and Femoral Neck Fractures in the Emergency Department: A Systematic Review

Ritcey

Pageau

Woo

et al. 2015

CJEM

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Objectives: Hip and femoral neck fractures are common in elderly patients, who are at an increased risk of complications if their pain is suboptimally managed. This systematic review seeks to determine if regional nerve blocks reduce pain, reduce the need for parenteral opiates, and reduce complications, compared to standard pain management with opiates, acetaminophen, or NSAIDs. Data sources: Systematic review of MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials found 401 articles, of which nine were selected for inclusion. Study selection: Randomized controlled trials including adult patients with a hip or femoral neck fracture (Population) who had a 3-in-1 femoral nerve block, traditional femoral nerve block, or fascia iliaca compartment block performed preoperatively (Intervention). Comparison must have been made with standard pain management with opiates, acetaminophen, or NSAIDs (Comparison) and outcomes must have included pain score reduction (Outcome). Data synthesis: Eight out of nine studies concluded pain scores were improved with the regional nerve block compared to standard pain management. A significant reduction in parenteral opiate use was seen in five out of six studies. No patients suffered life-threatening complications related to the nerve block; however, more minor complications were underreported. Most of the studies were at a moderate to high risk of bias. Conclusions: Regional nerve blocks for hip and femoral neck fractures have a benefit in reducing pain and the need for IV opiates. The use of these blocks can be recommended for these patients. Further high-quality randomized controlled trials are required. RÉSUMÉObjectifs: Les fractures de la hanche et du col du fémur sont fréquentes chez les personnes âgées, qui connaissent un risque accru de complications si le soulagement de la douleur n'est pas suffisant. La revue systématique présentée ici visait à déterminer si l'analgésie régionale par blocage nerveux permettait d'atténuer la douleur, de réduire la nécessité d'administrer des opiacés par voie parentérale et de diminuer le risque de complications comparativement au traitement habituel de la douleur par les opiacés, l'acétaminophène ou les anti-inflammatoires non stéroïdiens (AINS). Sources de données:Une revue systématique effectuée dans les bases de données MEDLINE, EMBASE, CINAHL et Cochrane Central Register of Controlled Trials a permis de relever 401 articles, dont 9 ont été retenus pour l'étude.Sélection des études: Il s'agissait d'essais comparatifs à répartition aléatoire, menés chez des adultes qui avaient subi une fracture de la hanche ou du col du fémur (population) et qui avaient été traités par un bloc fémoral « 3 en 1 », un bloc fémoral classique ou un bloc de la loge du fascia iliaque en phase préopératoire (intervention). Les comparaisons devaient avoir été établies avec le traitement habituel de la douleur par les opiacés, l'acétaminophène ou les AINS (comparaison) et les résultats devaient faire état d'une réduction du score d...

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Section: Resultsmentioning

confidence: 68%