A Randomized Controlled Trial Comparing a Fascia Iliaca Compartment Nerve Block to a Traditional Systemic Analgesic for Femur Fractures in a Pediatric Emergency Department

Wathen, Joe E.; Gao, Dexiang; Merritt, Glenn; Georgopoulos, Gaia; Battan, F. Keith

doi:10.1016/j.annemergmed.2006.09.006

Cited by 89 publications

(40 citation statements)

References 20 publications

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“…Thus accidental intraneural and intravascular injury can be avoided. [18][19][20] The results of this study will promote the practice of FICNB in our institute, which is part of the MSc course.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of fascia iliaca compartment nerve block as part of multimodal analgesia after surgery for femoral bone fracture

Kumie

Gebremedhn

Tawuye

2015

World Journal of Emergency Medicine

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BACKGROUND: Fascia iliaca compartment nerve block (FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture. METHODS:An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group (n=20) and a control group (n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the fi rst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale (VAS), total analgesic consumption, and the time for the fi rst analgesic request.RESULTS: VAS pain scores were reduced within the fi rst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values (IQR) 0.00 (0.00) vs.18.00 (30.00), P=0.001; at 6 hours 0.00 (0.00) vs. 34.00 (20.75), P=0.000; at 24 hours 12.50 (10.00) vs. 31.50 (20.75), P=0.004; and at 12 hours (17.80±12.45) vs. (29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged (417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.

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Section: Discussionmentioning

confidence: 99%

Efficacy of fascia iliaca compartment nerve block as part of multimodal analgesia after surgery for femoral bone fracture

Kumie

Gebremedhn

Tawuye

2015

World Journal of Emergency Medicine

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“…Although systemic opioids such as morphine and fentanyl are among the most frequently used analgesic agents administered by emergency medical and ambulance services, there is evidence to suggest that regional anesthesia may be an alternative for managing acute pain after a femoral fracture (14-23). Regional techniques to provide analgesia for femoral fractures include femoral nerve blocks and fascia iliaca compartment blocks (FICB) (12,13,(24)(25)(26)(27). Although femoral nerve blocks and FICB have been demonstrated to be effective in both the in-hospital and out-of-hospital settings when performed by physicians, there are no published studies of paramedic-performed regional anesthesia for suspected femoral fractures (2,19,22,25,27).…”

Section: Introductionmentioning

confidence: 99%

Paramedic-performed Fascia Iliaca Compartment Block for Femoral Fractures: A Controlled Trial

McRae

Bendall

Madigan

et al. 2015

The Journal of Emergency Medicine

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“…4,5 Few studies have demonstrated that a fascia iliac compartment (FIC) block provides effective analgesia for a fractured femur in terms of facilitating an adequate position for spinal anaesthesia or when administered either during pre-hospital management or in emergency departments. [6][7][8] Systemic analgesics, such as narcotics, are commonly used, but their side effects profile including respiratory depression, cognitive impairment, vomiting, urinary retention, and others limits their clinical utility during injuries of the head, chest, or abdomen. [9][10][11] Previous studies suggest that the use of local anesthesia using femoral nerve block (FNB) is a safe and effective method.…”

mentioning

confidence: 99%

Positioning for regional anesthesia in femur fracture surgeries: how effective is femoral nerve block? a randomised control study

Purohit¹,

Sireesha²,

Badami³

2017

Int J Res Med Sci

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Background: Fracture of the femur is a common orthopaedic problem following trauma in patients of all ages. This study was undertaken to evaluate the effectiveness of femoral nerve block (FNB) in positioning the patients for regional anesthesia.Methods: 100 patients between the ages 18 to 80 years, of ASA grade I, II and III, scheduled for elective surgeries of femur fracture were evaluated in 2 groups. Group FNB (n=50) received femoral nerve block with 15ml of 1.5% lignocaine and Group. Non FNB (n=50) was not given any block. Assessment of pain was carried out using visual analog scale (VAS). This was rated before, during and after the procedure of positioning for spinal/combined spinal epidural anesthesia (CSE). Vital parameters were tabulated.Results: VAS scores were noted at 0, 2, 5,10,15 minutes and at the time of positioning. VAS scores at 15 minutes after FNB was 1.473 ±0.1639 and 8.250±0.3615 in patients without FNB. Time taken for CSE was significantly less in FNB group (13.026±0.4628) minutes as compared to non FNB group (19.660 ±0.3742) minutes. Patient satisfaction scores were significantly higher in FNB group (45/50) 1.4952±0.033 as compared to non FNB group (10/50) 0.3460±0.1786. Quality of patient positioning was better in FNB group (2.782 ±0.1273) as compared to non FNB (1.382±0.2473).Conclusions:This study concludes that FNB is highly effective in giving good pain relief for positioning for regional anaesthetic procedures improving performance time and offers higher acceptance among patients with femoral fractures.

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A Randomized Controlled Trial Comparing a Fascia Iliaca Compartment Nerve Block to a Traditional Systemic Analgesic for Femur Fractures in a Pediatric Emergency Department

Cited by 89 publications

References 20 publications

Efficacy of fascia iliaca compartment nerve block as part of multimodal analgesia after surgery for femoral bone fracture

Efficacy of fascia iliaca compartment nerve block as part of multimodal analgesia after surgery for femoral bone fracture

Paramedic-performed Fascia Iliaca Compartment Block for Femoral Fractures: A Controlled Trial

Positioning for regional anesthesia in femur fracture surgeries: how effective is femoral nerve block? a randomised control study

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