A comparison the analgesic efficacy of Fascia iliaca compartment block and Femoral nerve block by ultrasound and intravenous fentanyl in femoral fracture patients before positioning for spinal anesthesia
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Abstract
Background: Positioning for spinal anesthesia in patients with fractured femur is severe pain. To concern this issue. This study provided an effective analgesia before positioning for spinal anesthesia.
Objectives: This prospective study was designed to compare the analgesic efficacy of ultrasound-guided fascia iliaca compartment block (FICB) femoral nerve block (FNB) and intravenous fentanyl (FENT) in femoral fracture patients before positioning for spinal anesthesia.
Methodology: A completely randomized design with 33 fractured femur patients were allocated into 3 groups (n = 11). Both the FICB and the FNB group received a mixture of 0.5% bupivacaine 20 cc and 2% lidocaine 10 cc and the FENT group received 0.5 mcg/kg of fentanyl intravenously. The patients’ pain was recorded by the numeric rating scale (NRS). Eight minutes during positioning for spinal anesthesia if NRS was > 5, the increments of fentanyl 0.5 mcg/kg were given every 5 minutes until NRS were ≤ 4 (maximum 1.5 mcg/kg). NRS were compared during positioning. Secondary
outcomes: the duration of procedure andthe quality of positioning were also compared. For statistical analysis, the Kruskal-Wallis test was used. The level of significance was set at 0.05.
Results: The median reductions in NRS of the FNB group were significantly less than the FICB and the FENT group (p=0.0066). However, there were no statistically significant differences between the groups for procedural time and quality of positioning before spinal anesthesia.
Conclusions: The ultrasound-guided femoral nerve block was more effective than the fascia iliaca compartment block and intravenous fentanyl for reducing pain in patients with fractured femur before spinal anesthesia.
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References
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