Key result
Ultrasound-guided fascia iliaca compartment nerve block prolonged postoperative analgesia duration compared to intravenous tramadol (460.31 vs 263.72 minutes, p=0.001) in proximal femur fractures.
Why the study?
This study evaluated the effectiveness of fascia iliaca compartment nerve block with bupivacaine and dexamethasone for postoperative analgesia in proximal femur fracture.
Does ultrasound guided FICNB with bupivacaine and dexamethasone improve postoperative analgesia in patients undergoing proximal femur fracture surgery compared to intravenous tramadol?
RCT (n=64)
Double-blind
Sealed envelope method
No
Does ultrasound guided FICNB with bupivacaine and dexamethasone improve postoperative analgesia in patients undergoing proximal femur fracture surgery compared to intravenous tramadol?
Absolute Event Rate: 460.31% vs 263.72%
p-value: p=0.001
Ultrasound-guided fascia iliaca compartment block with bupivacaine and dexamethasone significantly prolongs postoperative analgesia compared to intravenous tramadol in proximal femur fracture surgeries.
May enhance analgesia after proximal femur fracture; leaves open confirmation in larger trials.
Background Fascia iliaca compartment nerve block (FICNB) has been reported to provide effective postoperative analgesia in patients with femur fracture. This study aimed to evaluate the effectiveness of FICNB with Bupivacaine and Dexamethasone for postoperative analgesia in proximal fracture femur. Methods Sixty-four patients of ASA grade 1 to 3, aged 50-80 years scheduled for proximal femur fracture femur were included and randomly assigned to two groups of 32 patients each Group F received ultrasound guided(FICNB) with 0.25% 40ml of Bupivacaine & Dexamethasone 4 mg & Group T received Tramadol 50mg at the end of surgery. Postoperative pain was assessed at 30 minutes, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours and 24 hours using visual analogue scale (VAS). Injection Paracetamol 1gm was given intravenously as rescue analgesia in both the groups when VAS was more than four. Results Both the groups were comparable for demographic parameters. The mean duration of analgesia was 460.31±10.50 minutes in the FICNB group while it was only 263.72±12.85 minutes in the tramadol group, the difference being statistically significant (with a ‘p value’ of 0.001). The total consumption of paracetamol did not show a significant difference in either of the groups in the first 24 hours, the ‘p value’ being 0.406. Conclusion Ultrasound guided FICNB given postoperatively in patients undergoing proximal fracture femur can provide postoperative pain relief for longer duration than Inj. Tramadol.
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J. et al. (2020) conducted an RCT in Proximal fracture femur (n=64). Ultrasound guided fascia iliaca compartment nerve block (FICNB) vs. Intravenous Tramadol 50mg was evaluated on Mean duration of analgesia (minutes) (p=0.001). Ultrasound-guided fascia iliaca compartment nerve block prolonged postoperative analgesia duration compared to intravenous tramadol (460.31 vs 263.72 minutes, p=0.001) in proximal femur fractures.
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