Comparing Analgesic Effectiveness of Ultrasound Guided Femoral Nerve Block versus Fascia Iliaca Block for Positioning During Spinal Anaesthesia in Adult Patients Undergoing Femoral Fracture Surgery
Abstract
Background: Femoral fractures are highly painful and commonly require surgical fixation, typically performed under SAB (Subarachnoid Block). However, severe pain can hinder proper positioning for SAB. PNB (Peripheral Nerve Blocks), such as FNB (Femoral Nerve Block) and FICB (Fascia Iliaca Compartment Block) offer effective analgesia in these cases. Methods: This prospective observational study included 70 patients undergoing femur fracture surgery, divided into two groups: Group 1 (n=35) received ultrasound-guided FNB (15 ml of 0.25% bupivacaine), and Group 2 (n=35) received FICB before SAB. Parameters assessed included VAS during positioning, ease of interspinous space palpation, number of dural puncture attempts, patient satisfaction, and haemodynamic/respiratory changes. Results: Both blocks effectively reduced pain during positioning, but Group 2 (FICB) showed significantly lower VAS scores (p < 0.05), indicating superior analgesia. Both techniques had a similar onset of analgesia, achieving pain relief within 15 minutes (p < 0.05). Patient satisfaction was higher in the FICB group (p < 0.05). Quality of positioning, assessed by fewer spinal attempts, was also better in the FICB group (p < 0.05). No significant differences were observed between groups regarding interspinous palpation, haemodynamic, or respiratory changes. Conclusion: Preoperative FICB provides superior analgesia compared to FNB for SAB positioning in femur fracture surgeries, evidenced by lower VAS scores, better positioning, and higher patient satisfaction. Both techniques were safe with no significant impact on haemodynamics or respiration during positioning.Keywords:
Femoral Nerve Block, Fascia Iliaca Compartment Block, Spinal Anaesthesia, Bupivacaine, Visual Analogue Scale, Patient SatisfactionReferences
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