Key result
Fascia iliaca compartment block significantly reduced pain (VAS 2.70 vs 5.33, p<0.001) and improved patient positioning for subarachnoid block compared to intravenous fentanyl.
Why the study?
Proper positioning for subarachnoid block is impaired in femur fracture patients due to pain and joint immobility, requiring effective pain reduction strategies.
Does Fascia iliaca Compartment Block reduce pain and improve positioning compared to intravenous fentanyl in fracture femur patients undergoing subarachnoid block?
RCT (n=60)
Single-blind
Computer generated random series
No
Does Fascia iliaca Compartment Block reduce pain and improve positioning compared to intravenous fentanyl in fracture femur patients undergoing subarachnoid block?
Absolute Event Rate: 2.7% vs 5.33%
p-value: p=<0.001
Fascia iliaca compartment block provides superior pain relief and better patient positioning for subarachnoid block compared to intravenous fentanyl in patients with femur fractures.
Small Level 5 study of FICB vs fentanyl for SAB positioning; leaves open need for larger randomized confirmation.
Background: For performing successful Sub Arachnoid Block, proper positioning of patient is needed, which is affected in patients with fracture femur due to pain and immobility of joint.Aim/Objective: Aim is to reduce pain and to get better positioning for Sub Arachnoid Block in these patients by comparing Intravenous Fentanyl and Fascia iliaca Compartment Block.Material & Method: Six patients of fracture femur of age 30 to 60 years and of ASA Grade I and II were divided into 2 groups. 30 patients were given Intravenous Fentanyl @ 1mcg/kg and 30 patients were given Fascia iliaca Compartment Block with 20 ml of 0.25% Ropivacaine using Peripheral Nerve Stimulator (PNS) 30 mins before giving Sub Arachnoid Block.Adequacy of position and VAS for pain was noted at the time of sitting position for Sub Arachnoid Block along with hemodynamics and other side effects.Results: Pain reduction in Fascia iliaca Compartment Block group was better than Intravenous Fentanyl group (p value <0.05) and positioning for Sub Arachnoid Block was better in Fascia iliaca Compartment Block group as compared to Intravenous Fentanyl group (p value <0.05). Patients in FICB group were found to be more hemodynamically stable and experienced no side effects as compared to patients in Intravenous Fentanyl Group.Conclusion: Patient with Fascia iliaca Compartment Block were found to have lower pain/VAS and better positioning during Sub Arachnoid Block procedure.
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Agarwal et al. (2021) conducted an RCT in Fracture femur (n=60). Fascia iliaca Compartment Block (FICB) vs. Intravenous Fentanyl @ 1mcg/kg was evaluated on Visual analogue scale (VAS) score for pain at 30 minutes (p=<0.001). Fascia iliaca compartment block significantly reduced pain (VAS 2.70 vs 5.33, p<0.001) and improved patient positioning for subarachnoid block compared to intravenous fentanyl.
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