Fascia Iliaca Block versus Intra-Venous Analgesia for Positioning of Neck Femur Fracture in Patient Undergoing Spinal Anathesia

Abstract

Abstract Background Fracture of the femur is a well-known reason for surgical repair in patients of all ages. Locations include the neck, intertrochanteric, shaft, and distal fractures. Spinal anesthesia is the commonly used, preferred method for surgery and is associated with lower odds of mortality compared to general anesthesia. Spinal anesthesia is administered in either a sitting or lateral decubitus position. Positioning patients with a fractured femur for spinal anesthesia is challenging since minimal movement of the overriding fracture ends can cause extreme pain. Objective To elaborate the efficacy and safety of FICB with intravenous analgesic (IVA) on the quality for positioning before spinal anesthesia in participants with a femur fracture. Methods After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients were included in the study, and were divided into two groups (n = 25; each); group FICB and control group. Results The study results show that there was no statistically significant difference found between FICB group and FENT group regarding demographic data and characteristics of the studied patients. While there was statistically significant increase in the quality of patient positioning in FICB group than FENT group with p-value = 0.021; also there was statistically significant increase in the patient satisfaction in FICB group than FENT group with p-value =0.021. And a statistically significant increase was found in the time to first rescue analgesic postoperative in FICB group than FENT group with p-value < 0.001. Conclusion Fascia Iliaca Compartment Block is more efficacious than intravenous fentanyl for positioning during spinal anaesthesia in surgery for fracture femur. Fascia Iliaca Compartment Block provides superior analgesia, better quality of patient positioning, greater patient satisfaction thereby reducing the time taken to perform spinal anaesthesia in sitting position compared to i.v. fentanyl in fracture femur surgery.