Key result
Stimulator-guided femoral nerve block cuts VAS scores ~66% vs IV fentanyl in femur fractures.
Why the study?
Proximal femoral fractures require effective analgesia before surgical intervention, but optimal analgesic methods in this context need evaluation.
Does peripheral nerve stimulator guided femoral nerve block improve analgesia compared to IV fentanyl in patients undergoing surgery for femur fracture?
RCT (n=60)
Computer randomization scheme (randomization.com)
No
Does peripheral nerve stimulator guided femoral nerve block improve analgesia compared to IV fentanyl in patients undergoing surgery for femur fracture?
Peripheral nerve stimulator guided femoral nerve block provides superior analgesia and facilitates better positioning for neuraxial blockade compared to IV fentanyl in patients with femur fractures.
Answers are grounded in this paper and cite their sources.
Pre-anesthetic evaluation may optimize risk assessment in proximal femoral fracture patients; leaves open standardized protocols for outcome improvement.
Background: fractures occurring in elderly patients which require surgical intervention.Proximal femoral fractures are very common in patients older than 50 years which are mostly pathological.In younger patients, proximal femoral fractures are usually the result of high-energy physical trauma (eg.high speed motor vehicle accidents) and usually occur in the absence of disease.Subjects and Methods: A pre-anesthetic evaluation comprising of history of previous medical and surgical illnesses, previous anesthesia exposures, drug allergies and upper respiratory tract infection; clinical examination and baseline investigation of blood hemoglobin, radiograph of the chest and airway examination was done.Results: VAS score at rest and movement in femoral nerve block is less than Fentanyl after 25 minute.It shows that p value is significant (p<0.001) which indicates that VAS score at rest and movement after 25 minute is less in femoral nerve block than Fentanyl.Conclusion: Besides the excellent analgesic effect, the procedure used in group femoral nerve block showed a high feasibility.Femoral nerve block was easy to perform, even when patients' legs were placed in traction.
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S et al. (2019) conducted an RCT in Femur fracture requiring surgery (n=60). Peripheral Nerve Stimulator Guided Femoral Nerve Block vs. IV Fentanyl (1 microg/kg) was evaluated on VAS score at rest and movement at 15 minutes (p=<0.001). Peripheral nerve stimulator-guided femoral nerve block significantly reduced VAS scores at rest and movement compared to IV fentanyl after 15 minutes (p<0.001) in patients with femur fractures.
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