Background and aims: Patient positioning for spinal anaesthesia in femoral fractures is challenging. Peripheral nerve blocks and intravenous fentanyl are commonly practiced modalities to manage pain. However, results available in literature are conflicting, and there is need to decide best modality to manage pain. Methods: A comparative observational study was conducted among 104 American Society of Anaesthesiologists – physical status I to III patients in age group ,18 - 70 years, scheduled to undergo fractured femur fixation under sub arachnoid block. The participants were conveniently divided into 2 groups (n = 52 per group); ultrasound-guided Femoral Nerve Block (FNB) group and intravenous (IV) Fentanyl group. Fifteen minutes before spinal anaesthesia, participants in FNB received 15 mL of 1.5% lignocaine with adrenaline solution and fentanyl group received fentanyl 1 µg/kg intravenously. Hemodynamic parameters and pain scores were assessed at baseline, 10 minutes after analgesia, and during positioning. Results: There was significant reduction in pain scores in FNB group compared to IV fentanyl group (P = 0.001). Median performance time was shorter in FNB group (P = 0.001). The ease of positioning (P = 0.37) and patient satisfaction (P = 0.69) were comparable between groups. There were no adverse effects, and no participant in either group required additional rescue dose of fentanyl. Conclusion: It can be concluded that ultrasound-guided FNB was effective in reducing pain scores at baseline, 10 minutes after analgesia, and during positioning of patient for spinal anaesthesia. However, both modalities were equally effective in enabling ease of position and
Jeyakumar et al. (Sat,) studied this question.