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

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.

 

Corresponding Author : Richa Chandra, Associate Professor, Dept. of Anaesthesiology and Critical Care, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh 243001, India.