Fascia iliaca compartment block for femoral bone fractures in prehospital care

Lopez, Sandrine

doi:10.1053/rapm.2003.50134

Cited by 80 publications

(49 citation statements)

References 13 publications

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“…It was mainly used to provide analgesia following surgical procedures in the hip, femur and knee, treatment of burns on the thigh and in prehospital treatment of fracture femur [13,14].…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone as An Additive to Bupivacaine in Fascia Lliaca Compartment Block: A Prospective, Randomized and Double Blind Study

Kumar

Sebastian

2014

JCDR

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Background: Patients with fracture femur experience severe pain on movement during positioning for spinal anaesthesia. Fascia Iliaca Compartment Block (FICB) has been used effectively for providing analgesia during positioning of the patient for spinal anaesthesia. Aim:To test the hypothesis that, adding dexamethasone would significantly prolong the duration of Bupivacaine in FICB. Materials and Methods:Sixty patients aged 18 to 80 years posted for ORIF (Open Reduction and Internal Fixation) of fracture femur were included to receive FICB. This was a prospective, randomized, double blind study done at tertiary medical college hospital. Thirty patients received 38ml of 0.25 % bupivacaine with 2ml saline and another 30 patients received 38ml of 0.25 % bupivacaine with 2ml dexamethasone (8mg). Thirty minutes after FICB, patient satisfaction during positioning for spinal anesthesia was recorded. In the post-operative period, duration of analgesia and the total doses of rescue analgesics were recorded in both the groups. Results:Patients who received Bupivacaine with dexamethasone had significant prolongation of analgesia and required fewer doses of rescue analgesics as compared to patients who received Bupivacaine alone for FICB. However, the onset of analgesia, VAS scores and patient satisfaction during positioning for spinal anaesthesia were similar in both groups. Conclusion:Our study shows that adding Dexamethasone (8mg) to Bupivacaine for FICB significantly prolonged the duration of block and decreased the requirement of rescue analgesics as compared to patients who received Bupivacaine alone. FICB is relatively easy and safe to perform. In our study we did not encounter any complication while doing the procedures and also by adding dexamethasone.

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“…It was mainly used to provide analgesia following surgical procedures in the hip, femur and knee, treatment of burns on the thigh and in prehospital treatment of fracture femur [13,14].…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone as An Additive to Bupivacaine in Fascia Lliaca Compartment Block: A Prospective, Randomized and Double Blind Study

Kumar

Sebastian

2014

JCDR

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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.…”

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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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“…It was mainly used to provide analgesia following surgical procedures in hip, femur, knee, treatment of burns on thigh and in prehospital treatment of fracture femur 12,13 . Single shot fascia iliaca block provides effective analgesia for positioning of the patient with proximal femur fracture during spinal anesthesia and also provides postoperative analgesia.…”

Section: Discussionmentioning

confidence: 99%

Duration of post-operative analgesia with Fascia iliaca compartment block (ficb) using Bupivacaine with Dexmedetomidine and Bupivacaine with Dexamethasone in patients with proximal fracture femur

Sana

Pathak

Memon

2018

ijmsci

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ABSTRACT:Introduction: Fracture of proximal femur is a common occurrence following road traffic accidents and falls (in relatively older age group). These fractures are associated with considerable pain before surgery and in postoperative period. Effective pain management during positioning and in postoperative period is crucial and fascia Iliaca compartment block can be used effectively for this purpose in these patients. Many adjuvants like epinephrine, clonidine, Opioids, ketamine, dexamethasone and dexmedetomidine were combined with local anaesthetics to prolong the post-operative analgesia. We conducted this prospective study to know duration of post-operative analgesia with Fascia iliaca compartment block (ficb) using Bupivacaine with Dexmedetomidine and Bupivacaine with Dexamethasone in patients with proximal fracture femur. Materials and methods: This was a randomized, prospective, double blinded and controlled study done in the department of anesthesiology of a medical college situated in an urban area. 90 patients of either gender , ASA grade I & II ,the age of whom was between 18-80 years and who were undergoing surgery for proximal fracture femur under spinal anesthesia were enrolled in this study . All these patients received FICB by landmark technique before spinal anesthesia. The patients were divided in 3 groups. Group I -Patient in this group received 0.25% Bupivacaine plus normal saline 0.9%. Group II Patient in this group received 0.25% Bupivacaine plus dexamethasone. Group III Patient in this group received 0.25% Bupivacaine plus dexmedetomidine. Level of analgesia during positioning and in post operative period along with other parameters like sedation scores, VAS scores, hemodynamics and complications in these 3 groups were compared. Results: The study comprised of 90 patients out of which 45 (50%) were males and 45 (50%) were females with a M: F ratio of 1:1. ASA Grades and Mean duration of surgeries in these groups were comparable. For preoperative Pulse Rate, SBP, SpO2 the test used was One-Way ANOVA. p > 0.05 for all three parameters. There was no significant difference in onset of FICB and time required for giving spinal anesthesia in three groups (p>0.05). 27(90%) patients in group I, 25(83%) patients in group II and 26(87%) patients in group III had no sensation to pinprick thirty minutes after FICB. Preoperative pulse rate and pulse rate thirty minutes after FICB were compared .There was significant reduction in pulse rate (p<0.05) in group III 30 minutes after FICB. The analysis of changes in mean pulse rates showed that there was no significant difference in mean pulse rate intraoperatively (p>0.05). the study of postoperative duration of analgesia showed that There was highly significant difference in post-operative duration of analgesia between group I&II ,group I&III and group II&III . Conclusion: Addition of dexamethasone or dexmedetomidine to Bupivacaine for fascia iliaca compartment block in patients with proximal femur fracture further prolongs post-operative analgesia comp...

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Fascia iliaca compartment block for femoral bone fractures in prehospital care

Abstract: The fascia iliaca compartment block is a simple, inexpensive, and effective method of prehospital analgesia for femoral shaft fracture. A sensory block of the internal part of the thigh is an early predictive sign of optimal pain relief.

Cited by 80 publications

References 13 publications

Dexamethasone as An Additive to Bupivacaine in Fascia Lliaca Compartment Block: A Prospective, Randomized and Double Blind Study

Dexamethasone as An Additive to Bupivacaine in Fascia Lliaca Compartment Block: A Prospective, Randomized and Double Blind Study

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

Duration of post-operative analgesia with Fascia iliaca compartment block (ficb) using Bupivacaine with Dexmedetomidine and Bupivacaine with Dexamethasone in patients with proximal fracture femur

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