Aim of the Study: Comparison between ultrasound guided femoral block versus intravenous fentanyl for their analgesic effectiveness in ease of patient positioning for subarachnoid block. Materials and Methods: This double-blind study was planned with fifty patients of ASA 1 and ASA 2, aged between 20 to 80 years scheduled to undergo surgery for fracture neck of femur. It is a randomized prospective study where patients were allocated to two groups. Group A (N = 25) patients were given 10ml of Inj. Bupivacaine 0.5% for femoral nerve block with the help of ultrasound guidance. Group B (N = 25) patients received titrated doses. of Inj. Fentanyl 0.5mcg/kg I.V. This dosage was repeated to 3 doses with a total of 1.5 mcg with 5 minutes interval between the doses. Visual analogue scale was used 15 minutes after the block/I.V. Fentanyl i.e., during positioning to assess the analgesia provided. Sub arachnoid block was performed using appropriate dose of Inj. Bupivacaine (hyperbaric, dextrose 80mg/mL). was recorded by another anaesthesiologist blinded to the mode of analgesia with scores of 0-3. Results: Statistically significant difference was noted in VAS score among Group A (Mean = 1.44, SD = 1.583) and Group B (Mean = 2.96, SD = 2.010) with a p value of 0.044 (Chi Square test). Conclusion: From this study it can be concluded that in comparison to I.V Fentanyl, femoral nerve Block is more efficacious for ease of positioning during spinal anaesthesia in fracture neck of femur surgeries. Femoral nerve Block provides superior analgesia and better quality of patient positioning. This further aids in reducing the time taken to perform spinal anaesthesia in sitting position when compared to intravenous Fentanyl in fracture neck of femur surgery.
Kumar et al. (Sun,) studied this question.