Evaluation of two different dosages of local anesthetic solution used for ultrasound-guided femoral nerve block for pain relief and positioning for central neuraxial block in patients of fracture neck of the femur

Karmarkar, Abhijit A; Bhatnagar, Vidhu; Dwivedi, Deepak; Das, Asim K.

doi:10.4103/ijpn.ijpn_57_17

Cited by 2 publications

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“…There are some studies where FNB had been used to provide analgesia for positioning before giving SAB. [7][8][9]14,[20][21][22][23] We selected FNB because it is one of the easiest peripheral nerve block to perform, it's landmarks are easy as nerve is superficial and provides adequate analgesia even with lesser dose of local anaesthetics. 7 The use of a longacting local anaesthetic instead of lignocaine might have allowed more effective postoperative pain relief, but they may prolong the onset of action.…”

Section: Discussionmentioning

confidence: 99%

“…8 And also since we were to give intravenous fentanyl which is a sedative and can cause orthostatic hypotension especially in elderly patients, it is better to position the patients in lateral rather than sitting. 23 Other authors used sitting position for performing SAB in their studies as they might have thought of it as an easier way to leave traction in place during the procedure. 7,8 While Iamaroon A et al, Yun M J et al used lateral positioning for spinal anesthesia.…”

Section: Discussionmentioning

confidence: 99%

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Analgesic effect provided by femoral nerve block versus intravenous fentanyl prior to positioning for sub arachnoid block in patients with fracture femur- An open label, prospective, clinical study

George¹,

Dhimar²,

Upadhyay³

2020

IJCA

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Pain during positioning in patients with fracture femur results in improper position and makes subarachnoid block difficult. The aim of our study was to evaluate femoral nerve block and intravenous fentanyl for positioning the patient for subarachnoid block. Material and Methods: This open labelled prospective, clinical study was carried out in 60 patients aged 18-70 years of either sex, of ASAPS/ EASAPS-I, II and III, posted for fracture femur surgery under subarachnoid block and likely to have pain while positioning and who understand VAS score. Patients with contraindications to subarachnoid block, allergy to study drugs, history of drug or alcohol abuse, patient with multiple fractures and unable to understand VAS score were excluded from the study. Patients were assigned into two groups alternately in Group FNB (femoral nerve block was given) and Group FENT (intravenous Fentanyl 1µg/kg was given) for positioning before subarachnoid block. Assessment of pain was done using VAS score before and after positioning, time taken to achieve position, quality of position, patient acceptance and additional doses of fentanyl requirement during positioning. Patients were also observed for sedation score, pulse rate, NIBP and oxygen saturation. Results: VAS score 10 minutes after giving analgesia and during positioning was less in group FNB (1.97±0.56) as compared to group FENT (2.87±0.35), which was statistically very highly significant (P < 0.0001). None of the patient required additional dose in either group. Conclusion: FNB provides adequate analgesia, hence satisfactory positioning for sub arachnoid block with stable hemodynamics as compared to intravenous fentanyl.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analgesic effect provided by femoral nerve block versus intravenous fentanyl prior to positioning for sub arachnoid block in patients with fracture femur- An open label, prospective, clinical study

George¹,

Dhimar²,

Upadhyay³

2020

IJCA

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Effectiveness of Ultrasonography Guided Femoral Nerve Block for Patient Positioning during Central Neuraxial Block in Elderly Patients for Fracture of Femur - A Prospective, Randomized Control Trial

Barman¹,

Basumatary²,

Hazarika³

2021

jemds

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BACKGROUND Central neuraxial blocks, mainly spinal anaesthesia is the preferred anaesthesia over general anaesthesia in fracture of femur surgeries in elderly patients because of various side effects associated with general anaesthesia. However, the majority of the patients during positioning for spinal anaesthesia are associated with severe pain for which positioning becomes difficult. We wanted to assess the effectiveness of ultrasound (USG) guided femoral nerve block (FNB) to reduce pain during the positioning for spinal anaesthesia in fracture femur patients. METHODS It was a randomized control trial conducted on 80 elderly ASA I, II and III patients (45 - 70 years) posted for various femur surgeries under spinal anaesthesia having visual analogue scale (VAS) ≥ 4 during positioning. Patients in group FNB (N = 40) received USG guided femoral nerve block with 0.2 % ropivacaine and in control group (N = 40) didn’t receive any interventions preoperatively. All patients received injection fentanyl during positioning if VAS ≥ 4. Parameters recorded included VAS at baseline, 15 mins and during positioning, anaesthesiologist’s satisfaction (yes or no), total fentanyl consumption and patient’s satisfaction (Likert scale). RESULTS Demographic variables were comparable to each group. VAS in FNB at 15 mins and during positioning was 2.3 ± 1.042 and 3.025 ± 0.831 in comparison to 6.125 ± 0.607 and 7.2 ± 0.822 in control group respectively. Only 5 patients required injection fentanyl and total consumption was 142 ± 3.21 µg in FNB group while all patients in control group required injection fentanyl and total consumption was 1162 ± 4.43 µg. Anaesthesiologists and patients satisfaction were much higher in FNB group. CONCLUSIONS USG - guided FNB is very effective in controlling pain during positioning for spinal anaesthesia in fracture femur patients. KEY WORDS Ultrasound, Femoral Nerve Block, Spinal Anaesthesia, Ropivacaine, Fracture Femur

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Evaluation of two different dosages of local anesthetic solution used for ultrasound-guided femoral nerve block for pain relief and positioning for central neuraxial block in patients of fracture neck of the femur

Cited by 2 publications

References 0 publications

Analgesic effect provided by femoral nerve block versus intravenous fentanyl prior to positioning for sub arachnoid block in patients with fracture femur- An open label, prospective, clinical study

Analgesic effect provided by femoral nerve block versus intravenous fentanyl prior to positioning for sub arachnoid block in patients with fracture femur- An open label, prospective, clinical study

Effectiveness of Ultrasonography Guided Femoral Nerve Block for Patient Positioning during Central Neuraxial Block in Elderly Patients for Fracture of Femur - A Prospective, Randomized Control Trial

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