Key result
Continuous fascia iliaca block was superior to continuous lumbar plexus block in total consumed dose of morphine, sensory and motor block for 48 hours postoperatively (p=0.006).
Why the study?
Both continuous fascia iliaca block and continuous lumbar plexus block may decrease length of stay, morbidity, and support early ambulation, but their postoperative analgesic efficacy and opioid-sparing effects needed comparison in fractured neck of femur surgery.
Does continuous fascia iliaca block improve postoperative analgesia and patient satisfaction compared to continuous lumbar plexus block in patients undergoing fracture neck femur fixation?
RCT (n=40)
randomized
Does continuous fascia iliaca block improve postoperative analgesia and patient satisfaction compared to continuous lumbar plexus block in patients undergoing fracture neck femur fixation?
p-value: p=0.006
Continuous fascia iliaca block provides superior analgesia, better hemodynamic stability, and higher patient satisfaction compared to continuous lumbar plexus block after fracture neck femur fixation.
CFIB may offer better analgesia than CLPB after hip fracture fixation; leaves open need for larger confirmatory trials.
Background: It is thought that both CFIB and CLPB can decrease the length of hospital stay, morbidity and help early ambulation in patients with fracture neck of femur.Aim of the Study: To compare the postoperative analgesic efficacy and opioid spare effect of continuous ultrasound-guided lumbar plexus block and fascia iliaca compartment block in patients undergoing surgery for fractured neck of femur.Material and Methods: 40 patients with fracture neck femur were randomized intone of 2 blocks, CFIB and CLPB.Results: CFIB was superior to CLPB in total consumed dose of morphine, sensory and motor block for 48 hours postoperatively (p=0.006), hemodynamic stability (p<0.001), incidence of side effects (p=0.04) and patient satisfaction (p=0.06).Conclusion: Single injection lumbar plexus block provides postoperative analgesia for up to 18 hours, with avoidance of troubles of continuous infusion, with lower VAS scores and good patient satisfaction. However, it is considered a difficult technique with higher rate of complications and failure. On the other hand, Continuous infusion fascia iliaca block gives better quality analgesia, for up to 48 hours, and high patient satisfaction.
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HASSAN et al. (2019) conducted an RCT in Fracture neck of femur (n=40). Continuous Facia Iliaca Block (CFIB) vs. Continuous Lumbar Plexus Block (CLPB) was evaluated on Total consumed dose of morphine, sensory and motor block for 48 hours postoperatively (p=0.006). Continuous fascia iliaca block was superior to continuous lumbar plexus block in total consumed dose of morphine, sensory and motor block for 48 hours postoperatively (p=0.006).
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