Key result
Continuous fascia iliaca block resulted in significantly shorter catheter insertion time (P<0.001) and better intraoperative hemodynamic stability (P<0.001) compared to continuous lumbar plexus block.
Why the study?
In elderly and high-risk patients, local anesthesia is preferred over general anesthesia, but the comparative intraoperative performance of continuous fascia iliaca block versus continuous lumbar plexus block required assessment.
Does continuous fascia iliaca block improve intraoperative outcomes compared to continuous lumbar plexus block in patients undergoing fracture neck femur fixation?
RCT (n=40)
randomized
Does continuous fascia iliaca block improve intraoperative outcomes compared to continuous lumbar plexus block in patients undergoing fracture neck femur fixation?
p-value: p=<0.001
Continuous fascia iliaca block provides faster catheter insertion, earlier peak block, and better hemodynamic stability than continuous lumbar plexus block for fracture neck femur fixation.
May support fascia iliaca block for high-risk elderly; leaves open comparative efficacy versus lumbar plexus block.
Background: In the elderly and high risk patients, it is logic to prefer local anaesthesia rather than general anaesthesia. The fascia iliaca compartment block is an easy, available method for peri-operative analgesia in patients with painful conditions affecting the thigh, the hip joint and/or the femur. Lumbar plexus block is another form of deep blocks which is used to provide anesthesia and/or analgesia for the entire distribution of the lumbar plexus.Aim of Study: Intraoperative assessment of CFIB versus CLPB.Material and Methods: 40 patients with fracture neck femur were randomized intone of 2 blocks, CFIB and CLPB.Results: CFIB was significantly superior to CLPB as regards shorter time for catheter insertion (CIT) (p<0.001), earlier maximum motor block (p<0.001) and earlier peak of sensory block (p=0.008), intraoperative hemodynamic stability (p<0.001) while CLPB group showed significantly rapid onset of motor and sensory block (p<0.001, p<0.001).Conclusion: Continuous infusion fascia iliaca block gives better quality analgesia. It is an easy procedure that could be done in the emergency room. It is faster, safer and more applicable technique than continuous lumbar plexus block.
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HASSAN et al. (2019) conducted an RCT in fracture neck femur (n=40). Continuous Facia Iliaca Block (CFIB) vs. Continuous Lumbar Plexus Block (CLPB) was evaluated on Time for catheter insertion (CIT) (p=<0.001). Continuous fascia iliaca block resulted in significantly shorter catheter insertion time (P<0.001) and better intraoperative hemodynamic stability (P<0.001) compared to continuous lumbar plexus block.
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