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Fascia Iliaca Compartment Block with Ropivacaine Versus Intravenous Fentanyl in Patients with Fracture Femur

Richa Chandra, Associate Professor, Dept. of Anaesthesiology and Critical Care, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh 243001, India. , Mahesh Kashyap1 , Richa Chandra2 , Mohit Gupta3 , Nivedita4

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Indian Journal of Anesthesia and Analgesia 5(5):p 767-775, May 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5518.12

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Abstract

 

Introduction:  Fracture femur, a painful condition is common in the elderly patients with associated co-morbidities. Systemic NSAIDS increase the chances of epigastric pain, coagulation abnormalities where as opioids increases chances of delirium, altered sensorium, especially in this population [1]. Administration of block to overcome pain avoids the side effects of these analgesics. Proper patient positioning for regional anaesthesia is a challenge for the anaesthesiologists.  In this study our aim is  to compare perioperative analgesia and ease of patient positioning using fascia iliaca compartment block (FICB) and IV fentanyl. 

Objective: To compare the efficacy of FICB and IV fentanyl for perioperative analgesia, ease of positioning for spinal anaesthesia in patients with fracture femur, compare haemodynamic parameters. 

Method:  A prospective double blind study was conducted  on 60 ASA 1, 2 and 3 patients for 1 years in SRMS IMS, which were divided into 2 groups 30 patients in each group Group 1: Received the Fascia Iliaca compartment block with 20 ml of 0.2% Ropivacaine 15 minutes before the Subarachnoid block. Group 2: Received Intravenous fentanyl at 1 mcg/kg intravenously single dose15 minutes before the Subarachnoid block. VAS score, sitting quality and hemodynamic parameters were noted at regular time interval and were statistically analyzed. 

Discussion and Conclusion: FICB provides better positioning of the patient for spinal anaesthesia as compared to IV fentanyl and it also prolongs the duration of first postoperative analgesia.

Keywords: Fascia Iliaca Compartment Block; IV Fentanyl; Positioning; Fracture Femur.

 

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DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5518.12

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