EFFICACY OF ULTRASOUND GUIDED FEMORAL NERVE BLOCK VERSUS FASCIA ILIACA COMPARTMENT BLOCK FOR POSTOPERATIVE ANALGESIA IN PATIENTS WITH FEMUR FRACTURE: A HOSPITAL BASED COMPARATIVE STUDY.

Abstract

Objectives:  Femoral nerve block (FNB) is effective in providing analgesia for femur fractures. A Fascia Iliaca Compartment Block (FICB) is a modification of the femoral nerve block. The present study was to compare the efficacy of ultrasound guided femoral nerve block versus fascia iliaca compartment block for postoperative analgesia in patients with femur fracture. Methods: A total of 100 patients aged 18–65 years, American Society of Anesthesiologists (ASA) I or II, scheduled for elective unilateral proximal femur fracture surgery under spinal anesthesia were enrolled. All the patients were categorised into two groups (Group FICB and Group FNB). Group FICB (n = 50) received 25 ml and Group FNB (n = 50) got 15 ml of 0.25% bupivacaine under USG. Numerical rating scale (NRS) was recorded at 5, 8, 11, 14, 17, and 20 minutes. Results: At 5 minutes post block, Group FICB patients was lower NRS score as compared to Group FNB patients. While, it was not statistically significant differenced (p=0.1566). At 8, 11 and 14  minutes post block,  NRS score was significantly lower  (p<0.05) in group FICB patients as compared to  group FNB patients. At 17 and 20 minutes post block, NRS score in both group patients were same. At sitting position for SAB, group FICB patients was significantly (p<0.0001) lower NRS score as compared to group FNB patients. Time to first rescue analgesia was significantly longer (p<0.0001) in Group FICB patients (4.75±0.76 h) as compared with group FNB patients (2.68±0.84). Patient satisfaction score was significantly (p<0.0001) higher in group FICB as compared to group FNB. Conclusions: Ultrasound guided FICB is a relatively simple and less invasive technique. It provides effective postoperative analgesia and better comfort without increasing risk.