Ultrasound-guided three-in-one block versus landmark- based fascia iliaca compartment block for analgesia prior to positioning for spinal anesthesia in femur fracture patients | [Anaesthesia, Pain and Intensive Care • 2024]

Author(s):

1. Rhendra Hardy Mohamad Zaini: Department of Anesthesiology & Intensive Care, School of Medical Sciences & Hospital,Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan,Malaysia

2. Ikwan Wan Mohd Rubi: Department of Anesthesiology & Intensive Care, School of Medical Sciences & Hospital, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia

3. Wan Mohd Nazaruddin Wan Hassan: Department of Anesthesiology & Intensive Care, School of Medical Sciences & Hospital, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia

4. Umairah Esa: Department of Anesthesiology & Intensive Care, School of Medical Sciences & Hospital,Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan,Malaysia

5. Muhamad Aizuddin Ismail: Department of Anesthesiology & Intensive Care, School of Medical Sciences & Hospital,Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan,Malaysia

6. Praveena Seevaunnamtum: Department of Anesthesiology & Intensive Care, School of Medical Sciences & Hospital,Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan,Malaysia

7. Sanihah Che Omar: Department of Anesthesiology & Intensive Care, School of Medical Sciences & Hospital,Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan,Malaysia

Abstract:

Bac kg round & objective: Femoral bone fracture may cause considerable amount of pain. Many techniques have been described to ease pain in this group of patients. However, regional block technique remains underutilised and not regularly done. We evaluated the efficacy of ultrasound-guided (USG) 3-in-1 femoral nerve block versus the landmark-based single shot fascia iliaca compartment block as an analgesia method prior to positioning for spinal anesthesia in patients going for femur fracture surgery. Methodology: A total of 60 patients aged between 18 to 65 years old from ASA class I to III were included. They were divided into two groups by using computer assisted randomization. Group I received single shot landmark based-fascia iliaca compartment block whereas Group II received USG femoral 3-in-1 block. Ropivacaine 0.375% was used in both groups with a total volume depends on patient body weight. The pain score at rest, upon movement and at interval of 5-10 min after block performed recorded using Visual Analog Score. Results: Ultrasound guided femoral 3-in-1 block provides faster pain reduction at least 5-min post block (1.7 ± 0.75, P = 0.011) and significant relief at 20-min post block (1.33 ± 1.16, P = 0.026). Less intravenous fentanyl was required for rescue analgesia in Group II (10.83 ± 29.13, P = 0.018). Conclusion: Femoral 3-in-1 block provides much faster relief of pain in femoral bone fracture but both blocks are equally effective if given enough time to work out. Both are equally effective and appeared to be safe.

Page(s): 221-226

DOI: 10.35975/apic.v28i2.2425

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 28, Issue: 2, Year: 2024

Keywords:

Analgesia , Positioning , Ultrasound guided femoral 3in1 , Visual Analog Score , Femur fracture , Blind fascia iliaca compartment block

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