Nerve blocks for initial pain management of femoral fractures in children

How Effective Is a Regional Nerve Block for Treating Pain Associated With Hip Fractures?

“…The data supporting the use of regional nerve blocks in pediatric patients are significantly more limited. 14 Although more studies may be beneficial among pediatric patients and in the ED setting, this study supports the use of a regional nerve block for patients presenting with hip fractures in the ED setting. disagreements by discussion between the 2 reviewers.…”

Local anesthetic injection deep to the fascia iliaca at the level of the inguinal ligament: the pattern of distribution and effects on the obturator nerve

“…Since the initial publication of these methods, there has been controversy regarding the distribution of local anesthetic associated with their use and their ability to produce reliable ON block [3][4][5][6]. Despite these contentions, both the 3-in-1 and the FI compartment blocks continue to be tacitly validated in present-day literature [7][8][9]. To date, no studies of the 3-in-1 or FI compartment block have been performed using advanced imaging to document both exact needle position and accurate distribution of injectate.…”

Ultrasound-Guided Femoral Nerve Blocks

“…A Cochrane Collaboration analysis of the trial noted that at least 46% (12/26) of children in the fascia iliaca compartment block group had no supplementary medication (mainly analgesia) for the 6 hours of the study, whereas only 5% (1 or 2/28) of the children in the intravenous morphine group went without additional analgesia. 28 The complication rate for both groups was low, and there were no significant complications relating to anesthetic toxicity in the fascia iliaca block group. Strengths of the study include the use of 3 previously validated pain scales, inclusion of all analgesic doses (benzodiazepines, opioids), and follow-up for adverse effects during the observation period.…”