Abstract

Background: Hip fractures are a common and disabling injury caused by osteoporosis of the joints, and they have a significant socioeconomic impact. Any movement at the hip joint, whether during the transfer to the hospital or during a radiological procedure followed by OT, causes excruciating pain. Multiple comorbidities increase the need for regional analgesia and anaesthesia in elderly people. The primary purpose was to compare the analgesic efficacy of ultrasound guided supra inguinal FICB to that of PENG block for positioning during spinal anaesthesia. Comfort of anaesthetist while giving spinal anaesthesia and patient’s acceptance score were secondary objectives.
 Methods: The 60 patients in this prospective, double-blinded, randomized controlled research were scheduled to undergo elective surgery for hip fractures under spinal anaesthesia. They were allotted in two groups- group FICB(n=30) and group PENG(n=30). Ultrasound guided Supra inguinal FICB was performed in FICB group and PENG block was performed in the PENG group with 20ml of 0.25% bupivacaine in each group. Evaluation of pain before intervention, just before positioning and while positioning patients for spinal anaesthesia was done using NRS score. Comfort of the anaesthetist while positioning for spinal anaesthesia and patient acceptance was also assessed.
 Results: The NRS score did not differ significantly between the two groups (p= 0.853). On a scale of 0 to 3, the anaesthetist's comfort delivering spinal anaesthesia did not differ significantly between the two groups (p= 0.553). There was no statistically significant link between anaesthesia acceptance and group preference (p= 0.504)
 Conclusion: The newly invented PENG block to facilitate sitting positioning in fracture hip joint patients for spinal anaesthesia was equally effective to supra inguinal FICB.

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