Comparison of the Analgesic Effect of Pericapsular Ultrasound-Guided Nerve Group Block and Fascia Iliaca Block in Patients with Femoral Head Fracture for Neuraxial Block: A Pilot Study

Abstract

Background: Pelvic fractures are associated with a lot of pain. Objectives: This study aimed to compare pericapsular nerve and fascia iliaca block analgesia in the positioning of patients with femoral neck fractures for neuraxial anesthesia. Methods: In this double-blind clinical trial study, 50 patients (each group as a pilot: 25 patients) who were candidates for femoral neck fracture surgery were referred to Imam Khomeini Hospital in Urmia. They were randomly assigned (using random allocation software) to 2 groups, including pericapsular block and fascia iliaca block. Visual Analogue Scale (VAS) was used to evaluate analgesia. The pain level of the patients was checked before the block, 10 minutes after the block, and before positioning for neuraxial anesthesia. Results: Regarding gender, 38% (N = 19) were female, and 62% (N = 31) were male. The mean age of the patients was 57.38 ± 8.49 years without a significant difference between the 2 groups (P = 0.315). The mean body mass index of the patients was 26.44 ± 3.77 kg/m2 without a significant difference between the 2 groups (P = 0.243). The mean pain 10 minutes after the block was 1.72 ± 0.73 in the pericapsular group and 3.92 ± 0.86 in the fascia iliaca group (P < 0.001). The mean difference in pain was investigated before and after the block in the pericapsular and fascia iliaca groups (P < 0.001). Ten minutes after the block, the pain intensity was different in the pericapsular group and in the fascia iliaca. Moreover, there was no pain in the moderate classification in the pericapsular treatment group, while 16 patients (64%) had moderate pain in the fascia iliaca group. The differences were statistically significant (P < 0.001). Conclusions: This study shows that the pericapsular block may provide better analgesia for positioning in comparison to the fascia iliaca block in patients with femoral neck fractures.