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Ultrasound Guided Femoral Nerve Block: an Advanced Technique for Pain Relief in Emergency Department in Fracture Femur

Suman Choudhary, Resident, Department of Anaesthesiology, Bharati Vidyapeeth Medical College and Research Center, Pune-Satara Road, Pune, Maharashtra 411043, India. , Suman Choudhary1 , Sarita Swami2

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Indian Journal of Anesthesia and Analgesia 5(6):p 1022-1026, June 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.23

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Abstract

Background: Regional anaesthesia is an established method to provide analgesia for patients in the operating room and during postoperative phase. Ultrasound (USG) guided femoral nerve block offers advantage over intravenous anaesthesia in the acute phase of traumatized patients and during the initial transport of injured patients.The primary objective was to evaluate the pain relief in fracture femur patients using USG guided femoral nerve blocks on arrival in the emergency department. The secondary objective was to compare requirement of supplementation of analgesic and complications in both groups.

Methods: This prospective interventional study enrolled a sample of 60 patients with fracture femur, 30 in each group. Control group includes patient with conventional  analgesia while, in study group ultrasound-guided femoral nerve block was given with inj. bupivacaine 0.25% 10ml in plane approach. Pain score on movement and rest were assessed at baseline and 1 hourly after the procedure for 24 hours.

Results: All procedures required one attempt, no complications and there was 66% pain relief in study group as compared to control where only 44% relative decrease in pain scores was observed,(P<.005) 1hr to 24hr after procedure.

Conclusions: USG guided femoral nerve blocks are feasible to perform in the emergency department. Significant and sustained decreases in pain scores were achieved with this technique.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.23

Keywords

Fracture Femur; Femoral Nerve Block; Emergency Department; Ultrasound.

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