Combination of Fascia Iliaca Compartment Block on the Surgical Side with Sacral Spinal Anesthesia for Hip to Knee Surgery

Background and Aims: Different kinds of adjutants are used with local anesthetics during intrathecal procedure for prolongation of action. However, they are not completely free from side effects like postoperative hypoxia and cardiovascular instability. But subsequently, the use of preoperative femoral nerve block on surgical side provides beneficial analgesia to relieve fracture pain before operation, to make cooperative during administration of spinal anesthesia, to act as adjutants to intrathecal procedure and lastly to provide postoperative analgesia without side effect like central depression. Method: 50 (fifty) patients were administered fascia iliac compartment block (FICB) on the surgical side before intrathecal procedure with 30 ml of 0.5% injection ropivacaine. Sacral spinal anesthesia was administered through the first or second dorsal foramen of sacrum with 3 ml of 0.5% injection bupivacaine. Periodically, the estimation of blood pressure, heart rate and oxygen concentration was carried out. Results: 50 (fifty) patients were administered FICB successfully on surgical side preoperatively. Pain at the fractured site was relieved completely and all patients cooperated at the time of intrathecal procedure. Hemodynamic fluctuation was absent in operative period. Prolonged analgesia was noticed in postoperative period. Conclusion: High quality of analgesia, delivered by FICB is appropriate to relieve the pain in preoperative period from fractured site, to act as an adjutant to sacral spinal anesthesia during surgery and to provide prolonged analgesia after surgery without adverse reaction like hypoxia and central depression to combat surgical stress response.