Comparison Of Preoperative Ultrasound Guided Fascia Iliaca Block Versus Femoral Nerve Block for Proximal Femur Fractures Before Positioning for Spinal Anaesthesia

Sahara Medical College Narowal Pakistan84 enrolled

Overview

Proximal femur fractures are among the most painful orthopedic injuries Adequate analgesia is essential to facilitate positioning for spinal anesthesia, reduce opioid requirements, and minimize related complications. The aim of study to compare the analgesic efficacy of preoperative ultrasound-guided Fascia Iliac Block Versus and Femoral Nerve Block in patients with proximal femur fractures prior to positioning for spinal anesthesia.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Proximal Femur Fractures Nerve Block Assessment

Interventions

FNB was carried out as follows: the linear probe was kept in a "in line plane" approach to identify the femoral artery under ultrasound guidance. The triangular, hyperechoic femoral nerve was identified as being situated lateral to the femoral artery. The femoral artery was positioned next to an insulated 22 G needle. Once the needle tip was located and a negative blood aspiration was obtained, a little amount of local anesthetic (injection bupivacaine 0.25%) was administered. The remaining drug volume was injected based on weight (0.5 ml/kg) once the local anesthetic distribution was observed

Fascia Iliaca Nerve BlockPROCEDURE

The FICB was administered as described. We found the psoas muscle lateral to the femoral nerve. The iliacus fascia, which extends deep into the fascia Lata, covers it. Consequently, a double pop was felt after inserting the needle until it was between the psoas muscle and the fascia iliaca. As with the previously described method, 1 mL of the local aesthetic solution was injected, and following a negative blood aspiration, the medication disseminated beneath the fascia iliaca.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ASA I\&II status patients coming for proximal femur fracture surgery Exclusion Criteria: * Patients with history of neurological disease (Alzheimer, dementia), * Patients with known contraindication to regional anaesthesia (e.g., signs of infection at site of block, coagulation abnormality i.e. INR \>1.55, platelet count \<80,000) * Patients with ASA III and IV status and patients with Known allergy to the study drug were excluded from study.

Outcomes

Primary Outcomes

Pain Control

In patients with proximal femur fractures pain assessment was done baseline before blocks and at five minutes after blocks administration. Pain control assessment was done based on Visual Analogue Scale from 0-10.

Time frame: 05 minutes