Bloc iliofascial en médecine préhospitalière

Efficacy of Prehospital Analgesia with Fascia Iliaca Compartment Block for Femoral Bone Fractures: A Systematic Review

“…Gros, et al’s 31 observational study used a simple verbal pain score from zero to four to assess pain in patients before the block, 10 minutes after, and on arrival to the emergency department. The FICB was performed with no standardized technique, and a variety of different local anesthetics, volumes, and doses were used at the physicians’ discretion.…”

“…Initial eligibility screening with the inclusion criteria given above identified 13 papers which went on to have full-text eligibility screening. Of these, six studies were excluded 18,[28][29][30][31][32] (Table 1) and seven studies were selected for inclusion [33][34][35][36][37][38][39] (one randomized controlled trial [RCT], four prospective observational studies, one retrospective observational study, and one case report) with a total of 699 patients. Table 2 summarizes each included study with details on levels of evidence, patient numbers, treatments, and results, where appropriate.…”

“…Gozlan, et al 38 and Lopez, et al 39 both demonstrated a reduction in pain score following block administration. They were both prospective observational studies and did not have any comparator; due to the study designs, they were both given an OCEBM level of evidence of “2b.” Gros, et al 31 assessed 63 FICBs, but physicians were free to choose the dose and technique of the block. They were also permitted to use systemic analgesia, if desired, meaning the pain scores are hard to interpret and resulting in this study being assigned a OCEBM level of evidence of “4.” Minville, et al 37 describe a pain score reduction in a 6-year-old girl post-FICB, although IV paracetmol given before the block is performed making the pain score measurement unreliable.…”

“…They were both prospective observational studies and did not have any comparator; due to the study designs, they were both given an OCEBM level of evidence of "2b." Gros, et al 31 assessed 63 FICBs, but physicians were free to choose the dose and technique of the block. They were also permitted to use systemic analgesia, if desired, meaning the pain scores are hard to interpret and resulting in this study being assigned a OCEBM level of evidence of "4."…”

Fascia iliaca compartment block for femoral bone fractures in prehospital care

“…5 Its use in prehospital care is anecdotal. 6 As a nerve stimulator is not often available in ambulances, this would be an effective method of obtaining a lumbar plexus blockade. French physicians are present in prehospital units.…”