Key result
Ultrasound-guided femoral nerve block with 12 ml of local anesthetic was as effective as 15 ml for pain relief during positioning, with no significant difference in numeric rating scale scores.
Why the study?
Does 12 ml of local anesthetic solution provide similar pain relief compared to 15 ml for ultrasound-guided femoral nerve block in patients with fracture neck of the femur?
RCT (n=80)
Computer-generated random number table
Does 12 ml of local anesthetic solution provide similar pain relief compared to 15 ml for ultrasound-guided femoral nerve block in patients with fracture neck of the femur?
A 12 ml volume of local anesthetic is as effective as 15 ml for ultrasound-guided femoral nerve block to facilitate positioning for central neuraxial block in patients with femur neck fractures.
Supports 12 ml over 15 ml for femoral nerve block in hip fractures; confirms equivalent analgesia in this RCT.
Introduction: Surgical management of the fracture femur is preferred so as to prevent complications associated with prolonged immobilization. Central neuraxial blockade (CNB) is an attractive option for these patients, and an optimal positioning of the patient is a definite requirement. Owing to the pain associated with movement of the fractured limb, it becomes difficult for the patients to give suitable positioning. Femoral nerve block (FNB) features as a rescue analgesia so as to provide adequate analgesia for facilitation of satisfactory positioning. Aim: This study aims to compare analgesic effect of two different dosages of local anesthetic (LA) solution administered for ultrasonography (USG)-guided FNB given to facilitate optimal positioning for conduct of CNB. Materials and Methods: After taking permission from the institutional review board, eighty patients were enrolled in the study to find out the efficacy of dosage of LA solution for FNB in providing pain relief caused by movement of fractured limb during conduct of regional anesthesia. Informed consent was taken. All patients were given USG-guided FNB. Patients were randomized using a computer-generated random number table, into two groups of forty patients each. Group A patients received USG-guided 12 ml of LA solution containing 10 ml lignocaine solution without preservative (2%) plus 2 ml normal saline (NS), while Group B patients received USG-guided 15 ml of LA solution containing 13 ml lignocaine solution without preservative (2%) plus 2 ml NS for positioning before combined spinal epidural. Results: A total of eighty patients, divided randomly into two groups, were enrolled in the study. Demographics (age, sex, weight, and American Society of Anesthesiologists grades) were similar in both groups. No statistical significance was found in the numeric rating scale scores at baseline, zero minutes, 5, and 15 min in both the groups. Conclusion: USG-guided FNB with 12 ml of LA solution was as effective as 15 ml of LA solution for achieving adequate pain relief so as to give optimal positioning for CNB in patients of fracture neck of femur.
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Bhatnagar et al. (2017) conducted an RCT in Fracture neck of the femur (n=80). Ultrasound-guided femoral nerve block with 12 ml local anesthetic vs. 15 ml local anesthetic (13 ml 2% lignocaine + 2 ml normal saline) was evaluated on Numeric rating scale scores at baseline, 0, 5, and 15 minutes. Ultrasound-guided femoral nerve block with 12 ml of local anesthetic was as effective as 15 ml for pain relief during positioning, with no significant difference in numeric rating scale scores.
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