Abstract
Introduction: Blind fascia iliaca compartment block (FICB) and ultrasound guided femoral nerve block (FNB) are two types of peripheral nerve blocks, commonly used in preoperative pain management in patients with hip fractures in Danish emergency departments. The aim of this study was to compare the efficacy in pain management of these two types of peripheral nerve blocks in the preoperative period in patients with hip fractures. Method: We performed a randomized controlled study. The primary outcome was the proportion of patients with a numeric rating scale (NRS) pain score equal to three or less at rest and after passive leg raise test three hours after block administration. Results: A total of 88 patients were included in the study and 67 patients in the statistical analysis with 33 in the FICB group and 34 in the FNB group. The results showed a significant reduction in the proportion of patients with an NRS score higher than three, three hours after administration of either FICB or FNB compared to at inclusion. There was no significant difference in pain scores between patients receiving FICB versus patients receiving FNB at rest or after passive leg raise (p = 0.25 and p = 0.86, respectively). Conclusion: Blind FICB and ultrasound guided FNB were effective in preoperative pain management in patients with hip fractures. The results showed that the two types of peripheral nerve blocks were equally efficient in providing pain management in the preoperative period.
Highlights
Blind fascia iliaca compartment block (FICB) and ultrasound guided femoral nerve block (FNB) are two types of peripheral nerve blocks, commonly used in preoperative pain management in patients with hip fractures in Danish emergency departments
A total of 88 patients were included in the study and 67 patients in the statistical analysis with in the FICB group and in the FNB group
Since there was no significant difference between the two blocks in our study, we do not find the blind FICB preferable because most emergency departments (EDs) have ultrasound machines available which can visualize nerves and vascular structures and minimize potential damage
Summary
Blind fascia iliaca compartment block (FICB) and ultrasound guided femoral nerve block (FNB) are two types of peripheral nerve blocks, commonly used in preoperative pain management in patients with hip fractures in Danish emergency departments. The aim of this study was to compare the efficacy in pain management of these two types of peripheral nerve blocks in the preoperative period in patients with hip fractures. The results showed a significant reduction in the proportion of patients with an NRS score higher than three, three hours after administration of either FICB or FNB compared to at inclusion. The results showed that the two types of peripheral nerve blocks were efficient in providing pain management in the preoperative period. Studies have shown that regional anesthesia, including neuraxial and peripheral nerve blocks, is associated with lower incidence of pulmonary complications, postoperative cognitive dysfunction and a shorter length of stay in the intensive care unit (ICU) in this population [4] [8] [9]
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