Title: The Study of Effectiveness of Analgesia with Fascia Iliaca Compartment Block (FICB) for Positioning during Spinal Anaesthesia and the Duration of Post-Operative Analgesia Using Bupivacaine in Patients with Proximal Fracture Femur
Authors: Dr Syeda Sana, Dr Ramesh G. Pathak, Dr Nazima Memon
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.211
Abstract
Introduction: Fracture neck of femur is a common occurrence especially in elderly population. This is accompanied by severe pain and discomfort. Fascia Iliaca Compartment Block (FICB) is traditionally used by many anesthetists for preoperative pain relief with excellent results. The purpose of this study was to determine efficacy of FICB, to determine analgesic effect of FICB for positioning during spinal anaesthesia and to determine its efficacy for post-operative analgesia.
Materials and Methods: A case control study for determining effectiveness of analgesia with fascia Iliaca compartment block (FICB) for positioning during spinal anaesthesia and the duration of post-operative analgesia was conducted at a tertiary care hospital situated in an urban area. Total 60 patients were enrolled in this study. Control group and interventional group both consisted of 30 patients each. The control group received 40 ml NS while interventional group received 0.25% bupivacaine (38 ml) plus normal saline 0.9% (2ml) making total 40 ml. Hemodynamic stability, VAS score, Pinprick sensation and quality of analgesia were compared in control and interventional group.
Results: Mean age of patients in control and interventional group was 55.6 ± 12.25 and 54.80 ± 12.80 respectively. The mean duration of surgery was 2.05 ± 0.37 and 2.08 ± 0.42 in control and interventional group. In control group all patients (100%) had grade 0 analgesia while in interventional group 3 patients (10%) had grade I analgesia and 27 patients (90%) had grade 2 analgesia. There was a statistically significant difference in mean arterial pressure and heart rate during positioning at 30 minutes and control and intervention groups. There was statistically significant difference in VAS scores of these 2 groups from 30 minutes to 12 hours postoperatively. The difference between control and intervention groups for return of pinprick sensation was also found to be statistically significant.
Conclusion: FICB using 0.25% Bupivacaine is a rapid and effective method for positioning of patient and post-operative pain relief in patients undergoing surgery for fracture neck of femur under spinal anaesthesia.
Keywords: Fracture neck of femur, Fascia Iliaca Compartment Block, Bupivacaine, Post-operative analgesia.
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